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Author FM

Last update 15/3/97

The role of aspirin in vascular disease was recently reviewed in the BJGP, in a discussion paper entitled "Who needs antiplatelet therapy" by Moher et al. They developed some guidelines based on the findings of the Antiplatelet Trialists' Collaboration published in the BMJ in 1994

Aspirin treatment guidelines a practical guide

Acute myocardial infarction
Aspirin 300 mg (chewed) should be given immediately to all patients with suspected or definite MI

Past history of MI
Aspirin 150 mg/day should be given to all patients and continued indefinitely

Unstable angina
Aspirin 300 mg Should be given immediately to all patients with unstable angina

Chronic Stable Angina
Aspirin 75-150 mg/day should be given to all patients and continued indefinitely

Patients after revascularisation
Post coronary bypass graft: Aspirin 150-300 mg /day to all patients indefinitely
Coronary angioplasty: 150-300 mg/day to all patients indefinitely

Peripheral vascular disease/surgery
Aspirin 150-300 mg/day to all patients with peripheral vascular disease indefinitely
Aspirin 75-150 mg/day to all patients post carotid endartectomy indefinitely

Atrial fibrillation
Warfarin is best used in patients with a high risk of stroke whilst in those with low risk at a dose of 75-150 mg/day indefinitely and those high risk patients who cannot take warfarin

Past history of a TIA or non haemorrhagic stroke.
Aspirin 75-150 mg/day to all patients indefinitely

Contraindications to aspirin treatment.

• a definite history of hypersensitivity
• high risk of bleeding ( e.g. active peptic ulceration, major injury or bleeding diathesis