Aspirin and coronary heart disease

Abstract

Given the dramatic benefits of aspirin use early in the course of acute myocardial infarction (MI) demonstrated in the Second International Study of Infarct Survival (ISIS-2), immediate therapy of all acute MI patients should include at least one chewed aspirin tablet. Similarly, data from four major clinical trials have demonstrated the beneficial effects of aspirin in patients with unstable angina. Clinical trial data supporting the value of aspirin in patients with chronic stable angina, although less impressive than those for the acute ischemic syndromes, still indicate that low-dose aspirin should be part of these patients' therapeutic regimen. The potential role of aspirin in primary prevention is somewhat controversial. At present, chronic aspirin therapy should be used for this purpose only in the older male patient who has two or more major risk factors for coronary artery disease.