Current Cardiology Reports

, Volume 12, Issue 4, pp 344–347 | Cite as

Aspirin for Acute Coronary Syndromes: Have We Learned the Correct Dose Yet?

Article
First Online:

Abstract

Despite its universal use, the optimal dose of aspirin from an efficacy and safety perspective remains unclear. There are wide variations in international practice and a lack of consensus as to the most appropriate dose of aspirin in patients with acute coronary syndromes (ACS), mainly because of the wide range of doses evaluated in early randomized trials of aspirin versus placebo. Comparisons of aspirin dose have been based on observational studies or indirect comparisons from meta-analysis of antiplatelet trials. These studies have suggested that aspirin, in doses ≥300 mg, is similar to aspirin doses 75–100 mg/d for prevention of major vascular events, but that higher doses increase the risk of major bleeding complications. Recently, the CURRENT-OASIS study, a randomized head-to-head comparison of higher-dose (≥300 mg/d) versus low-dose aspirin (75–81 mg/d) for 1 month in over 25,000 patients with ACS referred for an early invasive strategy demonstrated similar outcomes between higher- and low-dose aspirin for efficacy, with no difference in the risk of major bleeding complications. Results from this mega-trial suggest that low-dose or higher-dose aspirin is a reasonable option in ACS patients undergoing an early invasive strategy.

Keywords

Dose Aspirin Acute coronary syndrome 

Clinical Trial Acronyms

BRAVO

Blockade of the GPIIb/IIIa Receptor to Avoid Vascular Occlusion

CHARISMA

Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance

CURE

Clopidogrel in Unstable Angina to Prevent Recurrent Ischemic Events

CURRENT-OASIS 7

Clopidogrel Optimal Loading Dose Usage to Reduce Recurrent Events and Optimal Antiplatelet Strategy for Interventions 7

ISIS-2

Second International Study of Infarct Survival

PCI-CURE

Percutaneous Coronary Intervention-Clopidogrel in Unstable Angina to Prevent Recurrent Ischemic Events

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Notes

Disclosure

No potential conflicts of interest relevant to this article were reported.

References

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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Hamilton Health SciencesDavid Braley Cardiac Vascular and Stroke InstituteHamiltonCanada

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