After patients with acute coronary syndromes (ACS, a group of symptoms related to acute ischemia, or chest pain related to arterial damage) undergo percutaneous coronary interventions (PCI, including stenting), a significant concern among cardiologists is the risk of major internal bleeding. Aspirin (ASA) acts as a blood thinner to prevent clotting complications, but high levels can cause potentially serious bleeding.
While PCI trials have traditionally used high-dose ASA (more than 200 mg) in combination with other medicines to prevent thrombosis and ischemic events, a sub-analysis from a clinical trial presented by researchers at McMaster University in Hamilton, Ontario suggests that low-dose aspirin may be just as effective as high doses to prevent thrombosis while reducing the risk of major bleeding in patients who have undergone PCI.
Researchers compared the safety and efficacy of varying doses of aspirin: low (less than 100 mg), intermediate (101-199 mg) and high (more than 200 mg). A total of 2,658 patients with ACS undergoing PCI were divided according to the most commonly used dose, and each dose group was evaluated for event rates relating to cardiovascular death, heart attack or stroke as well as major bleeding.
The researchers found similar rates of cardiovascular death, heart attack or stroke in all of the aspirin dose groups at 30 days and 8 months. While the incidence of major bleeding was not significantly different between the groups at 30 days, the rate of major bleeding was noticeably reduced with low-dose aspirin after 8 months, an important factor in the practice of aspirin dosing for patients in this population.
MEDICA.de; Source: American College of Cardiology