Aspirin as an Antiplatelet Drug

doi:10.1056/NEJM199405053301808

Volume 330:1287-1294		May 5, 1994		Number 18

Aspirin as an Antiplatelet Drug

Carlo Patrono

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The past 10 years have witnessed major changes in our understandingof the pathophysiologic mechanisms underlying vascular occlusion¹^,²and considerable progress in the clinical assessment of aspirinand other antiplatelet agents³^,⁴^,⁵. The purpose of this reviewis to describe a rational basis for antithrombotic prophylaxisand treatment with aspirin. Basic information on the molecularmechanism of action of aspirin in inhibiting platelet functionwill be integrated with the appropriate clinical pharmacologicdata and the results of randomized clinical trials.

Mechanism of Action

Aspirin induces a long-lasting functional defect in platelets,clinically detectable as a prolongation of the bleeding time.This appears to . . . [Full Text of this Article]

Clinical Pharmacology of the Antiplatelet Effect of Aspirin

Aspirin for the Secondary Prevention of Occlusive Vascular Disease

Unstable Angina and Non-Q-Wave Myocardial Infarction

Suspected Evolving Myocardial Infarction and Nonfatal Myocardial Infarction

Transient Cerebral Ischemia and Stroke

Ongoing Trials

Aspirin for the Primary Prevention of Occlusive Cardiovascular Disease

Healthy Subjects

Patients with Stable Chronic Angina

Patients with Diabetes Mellitus

Ongoing Trials

Maintenance of Vascular Grafts or Arterial Patency

Other Cardiovascular Conditions

Safety of Aspirin as an Antiplatelet Drug

Gastrointestinal Side Effects

Bleeding Complications

Renal Disease and Drug Interactions

Conclusions

Source Information

From the Departments of Pharmacology and Medicine, University of Chieti "G. D'Annunzio" School of Medicine, Chieti, Italy.

Address reprint requests to Dr. Patrono at Universita degli Studi "G. D'Annunzio," Facolta di Medicina e Chirurgia, Via dei Vestini, 31 66013 Chieti, Italy.

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