Aspirin: new cardiovascular uses for an old drug.
Inhibition of TXA2-dependent platelet function by aspirin may lead to prevention of  thrombosis as well as to excess bleeding. The balance between the two depends  critically on the absolute thrombotic versus hemorrhagic risk of the patient. As the  risk of experiencing a major vascular event increases, so does the absolute benefit of  antiplatelet prophylaxis with aspirin [Figure-see text]. The antithrombotic effect of aspirin  does not appear to be dose related over a wide range of daily doses (30 to 1,300  mg), an observation consistent with saturability of platelet COX-1 inhibition by  aspirin at very low doses. In contrast, GI toxicity of the drug does appear to be dose  related, consistent with dose- and dosing interval-dependent inhibition of COX-1  activity in the nucleated lining cells of the GI mucosa. Thus, aspirin once daily is  recommended in all clinical conditions where antiplatelet therapy is effective.  Because of safety considerations, physicians are encouraged to use the lowest dose  of aspirin shown effective in each clinical setting [Table-see text].
Patrono
C
C
Department of Medicine and Aging, University of Chieti G. D'Annunzio School of Medicine, Chieti, Italy. cpatrono@unich.it
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin