This Journal feature begins with a case vignette highlightinga common clinical problem. Evidence supporting various strategiesis then presented, followed by a review of formal guidelines,when they exist. The article ends with the author's clinicalrecommendations.
A 45-year-old man with a strong family history of prematureheart disease has no symptoms of coronary disease and has anormal electrocardiogram. A fasting lipid analysis reveals atotal cholesterol level of 225 mg per deciliter (5.8 mmol perliter), a high-density lipoprotein cholesterol level of 35 mgper deciliter (0.9 mmol per liter), a triglyceride level of150 mg per . . . [Full Text of this Article]
The Clinical Problem
Strategies and Evidence
Observational Studies
Randomized Trials
Areas of Uncertainty
Aspirin Dose
Benefits in Specific Subgroups
Other Benefits
Aspirin Resistance
Dual Antiplatelet Therapy
Guidelines
Conclusions and Recommendations
Source Information
From the Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland.
Address reprint requests to Dr. Lauer at the Department of Cardiovascular Medicine, Desk F25, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, or at lauerm@ccf.org.
Leshno, M., Moshkowitz, M., Arber, N.
(2008). Aspirin is Clinically Effective in Chemoprevention of Colorectal Neoplasia: Point. Cancer Epidemiol. Biomarkers Prev.
17: 1558-1561
[Full Text]
MADHWAL, S., LINCOFF, A. M., ROLSTON, D. D.K.
(2008). Q: Should patients on long-term warfarin take aspirin for heart disease?. Cleveland Clinic Journal of Medicine
75: 206-208
[Full Text]
Patrono, C., Rocca, B.
(2008). Aspirin: Promise and Resistance in the New Millennium. Arterioscler. Thromb. Vasc. Bio.
28: s25-s32
[Abstract][Full Text]
Lauer, M. S.
(2007). Primary Prevention of Atherosclerotic Cardiovascular Disease: The High Public Burden of Low Individual Risk. JAMA
297: 1376-1378
[Full Text]
Michos, E. D., Ardehali, R., Blumenthal, R. S., Lange, R. A., Ardehali, H.
(2006). Aspirin and Clopidogrel Resistance. Mayo Clin Proc.
81: 518-526
[Abstract][Full Text]
Jermany, J., Branson, J., Schmouder, R., Guillaume, M., Rordorf, C.
(2005). Lumiracoxib Does Not Affect the Ex Vivo Antiplatelet Aggregation Activity of Low-Dose Aspirin in Healthy Subjects. J Clin Pharmacol
45: 1172-1178
[Abstract][Full Text]
Campbell, P. J., Green, A. R.
(2005). Management of Polycythemia Vera and Essential Thrombocythemia. ASH Education Book
2005: 201-208
[Abstract][Full Text]
Hur, C., Simon, L. S, Gazelle, G S.
(2005). Analysis of Aspirin-Associated Risks in Healthy Individuals. The Annals of Pharmacotherapy
39: 51-57
[Abstract][Full Text]
Gill, T. M., Allore, H. G., Holford, T. R., Guo, Z.
(2004). Hospitalization, Restricted Activity, and the Development of Disability Among Older Persons. JAMA
292: 2115-2124
[Abstract][Full Text]
Wiggins, B. S., Spinler, S.
(2004). Antiplatelet and Antithrombin Therapy for Early Management of Acute Coronary Syndromes. Journal of Pharmacy Practice
17: 347-369
[Abstract]
Aktas, M. K., Ozduran, V., Pothier, C. E., Lang, R., Lauer, M. S.
(2004). Global Risk Scores and Exercise Testing for Predicting All-Cause Mortality in a Preventive Medicine Program. JAMA
292: 1462-1468
[Abstract][Full Text]
Patrono, C., Coller, B., FitzGerald, G. A., Hirsh, J., Roth, G.
(2004). Platelet-Active Drugs: The Relationships Among Dose, Effectiveness, and Side Effects: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest
126: 234S-264S
[Abstract][Full Text]
Cox, E. R., Frisse, M., Behm, A., Fairman, K. A.
(2004). Over-the-Counter Pain Reliever and Aspirin Use Within a Sample of Long-term Cyclooxygenase 2 Users. Arch Intern Med
164: 1243-1246
[Full Text]
Wajed, J., Ahmad, Y., Durrington, P. N., Bruce, I. N.
(2004). Prevention of cardiovascular disease in systemic lupus erythematosus--proposed guidelines for risk factor management. Rheumatology (Oxford)
43: 7-12
[Full Text]
Kimmel, S. E, Strom, B. L
(2003). Giving aspirin and ibuprofen after myocardial infarction. BMJ
327: 1298-1299
[Full Text]
Sacco, M., Pellegrini, F., Roncaglioni, M. C., Avanzini, F., Tognoni, G., Nicolucci, A.
(2003). Primary Prevention of Cardiovascular Events With Low-Dose Aspirin and Vitamin E in Type 2 Diabetic Patients: Results of the Primary Prevention Project (PPP) trial. Diabetes Care
26: 3264-3272
[Abstract][Full Text]
Hawk, E T, Viner, J L
(2003). Aspirin: still learning about the wonder drug. Gut
52: 1535-1536
[Full Text]
Dornbrook-Lavender, K. A, Pieper, J. A, Roth, M. T
(2003). Primary Prevention of Coronary Heart Disease in the Elderly. The Annals of Pharmacotherapy
37: 1654-1663
[Abstract][Full Text]
Balk, E. M., Lau, J., Goudas, L. C., Jordan, H. S., Kupelnick, B., Kim, L. U., Karas, R. H.
(2003). Effects of Statins on Nonlipid Serum Markers Associated with Cardiovascular Disease: A Systematic Review. ANN INTERN MED
139: 670-682
[Abstract][Full Text]
Zimmerman, M. A., Selzman, C. H., Cothren, C., Sorensen, A. C., Raeburn, C. D., Harken, A. H.
(2003). Diagnostic Implications of C-Reactive Protein. Arch Surg
138: 220-224
[Abstract][Full Text]
Davi, G., Guagnano, M. T., Ciabattoni, G., Basili, S., Falco, A., Marinopiccoli, M., Nutini, M., Sensi, S., Patrono, C.
(2002). Platelet Activation in Obese Women: Role of Inflammation and Oxidant Stress. JAMA
288: 2008-2014
[Abstract][Full Text]
Mehta, J.L., Mascitelli, L., Pezzetta, F., Lauer, M. S.
(2002). Aspirin for the Primary Prevention of Coronary Events. NEJM
347: 948-948
[Full Text]
Petitti, D. B.
(2002). Hormone Replacement Therapy for Prevention: More Evidence, More Pessimism. JAMA
288: 99-101
[Full Text]