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June 1991

An Apple a Day or an Aspirin a Day?

Arch Intern Med. 1991;151(6):1066-1069. doi:10.1001/archinte.1991.00400060014003

In 1989, the Second American College of Chest Physicians (ACCP) Conference on Antithrombotic Therapy1 recommended that aspirin, 325 mg/d, should be considered for all individuals with evidence of coronary artery disease and in those with risk factors for coronary artery disease. Aspirin, 1 g/d, was also recommended by the ACCP Panel2 for patients with transient ischemic attacks (TIAs), or a history of stroke. These recommendations, which apply to millions of Americans, were based on the results of a long series of reports and clinical trials dating back to 1948.

The recommendation that all individuals with evidence of coronary artery disease should take aspirin daily is based on the results of aspirin treatment in survivors of acute myocardial infarction,3-9 patients with unstable angina,10-12 patients with acute myocardial infarction,13 patients surviving coronary artery bypass grafting,14 and patients undergoing percutaneous transluminal coronary angioplasty.15,16 The recommendation for

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