Aspirin and the prevention of ischemic heart disease. A Socratic dialogue between a cardiologist, a clinical pharmacologist and an expert of blood platelets.
The recent publication of the results of the "Progetto di Prevenzione Primaria" by a large Italian group of researchers and general practitioners, prompts a cardiologist, a clinical pharmacologist and a blood platelet expert to review - using a Socratic dialogue style--the data on aspirin as a prototypal drug in the prevention of ischemic heart disease. The distinction between primary and secondary prevention seems to be rather artificial as it is based on past events and not on the risk of future events. Although aspirin proved to be effective in reducing both vascular mortality and non-fatal vascular events and is inexpensive, it is still underused for prevention by many physicians. The major indications on the beneficial effect of aspirin against ischemic heart disease derive from large epidemiological trials and are valid for populations rather than for single patients. Hopefully, biochemical markers such as C-reactive protein or genetic polymorphism will help to establish the effects of aspirin in more targeted groups or even in individuals.
de Gaetano
G
G
Center for High Technology Research and Education in Biomedical Sciences, Catholic University of the Sacred Heart, Campobasso, Italy. degaetano@cotir.it
D001241:Aspirin / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000032:analysis; D006801:Humans; D017202:Myocardial Ischemia / Q000235:genetics / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011110:Polymorphism, Genetic
D010975:Platelet Aggregation Inhibitors; D002097:C-Reactive Protein; D001241:Aspirin