ANTITHROMBOTIC properties of aspirin were first proposed 25 years ago when aspirin was shown to inhibit platelet aggregation and to prolong bleeding time,1-5 but it is only in the past 10 years that the therapeutic benefit of aspirin's antithrombotic properties has been conclusively established by randomized controlled trials.6-14 Early studies used relatively large aspirin doses of approximately 1000 mg, but with increased understanding of the mechanism of its antithrombotic effect, lower-dose regimens were evaluated and were shown to be as effective with less gastrointestinal side effects.7,15,16 Antithrombotic benefit from aspirin has been demonstrated with as little as 75 mg/d for unstable angina,8 160 mg/d for acute myocardial infarction,17 100 mg/d for aortocoronary grafts,18,19 and probably as little as 30 mg/d for minor cerebral ischemic events.16
The trend to use low doses of aspirin increases compliance and reduces gastrointestinal side effects but has the potential
Kearon C, Hirsh J. Optimal Dose for Starting and Maintaining Low-Dose Aspirin. Arch Intern Med. 1993;153(6):700–702. doi:10.1001/archinte.1993.00410060012002
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