![]() ![]() 1 One possible explanation for underuse of aspirin by physicians is concern regarding the potential for serious adverse effects on the gastrointestinal tract (GI).Ĭardiovascular disease, which includes myocardial infarction, stroke, and peripheral vascular diseases, is a leading cause of death in the United States and other major developed countries, accounting for more than 900 000 deaths annually in the United States alone. In spite of the clear evidence of benefit of aspirin in the secondary prevention of vascular events, its use in patients at high risk due to a previous event remains suboptimal. Data from numerous controlled clinical trials provided the basis for its approval by the US Food and Drug Administration (FDA) for use in prevention of thromboembolic events in individuals who had a previous myocardial infarction, transient ischemic attack (TIA), or stroke. More than 100 years after its introduction, it is now clear that aspirin can positively affect the heart, especially in the management of acute evolving myocardial infarction. Ironically, aspirin was advertised in the 1920s with the claim that it did not affect the heart, unlike other drugs of the time, which were thought to have an "enfeebling" effect. SINCE ITS introduction in 1899, aspirin has been recognized as a drug with a favorable benefit-to-risk ratio. The number needed to treat for aspirin to prevent 1 death from any cause of mortality was 67, while 100 needed to be treated to detect 1 nonfatal gastrointestinal tract bleeding.Ĭonclusion Aspirin use for the secondary prevention of thromboembolic events has a favorable benefit-to-risk profile and should be encouraged in those at high risk. Alternately, patients who took aspirin were 2.5 times more likely than those in the placebo group to have gastrointestinal tract bleeding. In addition, aspirin use reduced the number of strokes by 20%, myocardial infarctions by 30%, and other "vascular events" by 30%. Results Aspirin reduced all-cause mortality by 18%. Objective To compare the benefit and gastrointestinal risk of aspirin use for the secondary prevention of thromboembolic events.ĭesign A meta-analysis was conducted using 6 trials (6300 patients) meeting the inclusion requirement of use of low-dose aspirin (≤325 mg/d) in approved secondary prevention indications. A possible explanation for this underuse is concern regarding the relative benefit in relation to the potential risk for serious gastrointestinal events. ![]() Shared Decision Making and Communicationīackground In spite of the clear evidence of benefit of aspirin in the secondary prevention of cerebrovascular and cardiovascular thrombotic events, its use in patients at high risk due to a previous event remains suboptimal.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |