Effects of aspirin on coronary reocclusion and recurrent ischemia after thrombolysis: a meta-analysis

Reocclusion of infarct-related coronary arteries within 2 weeks of thrombolytic therapy varies from 5% to 45% and neither clinical nor angiographic variables have been proved to be predictive of reocclusion. The goal of the present study was to evaluate whether aspirin could prevent coronary reocclusion and recurrent ischemia after thrombolysis. For this purpose, a meta-analysis including 32 studies was performed. Although the studies showed very similar demographic data, the reocclusion rate assessed by angiography in 419 patients treated with aspirin was 11% compared with 25% in 513 patients without aspirin therapy (p less than 0.001). Recurrent ischemic events were present in 25% of 2,977 patients treated with aspirin and 41% of 721 patients treated without aspirin (p less than 0.001). The effect of aspirin was similar in trials with either streptokinase or recombinant tissue-type plasminogen activator (rt-PA). Thus, aspirin in the presence of heparin might prevent coronary reocclusion after thrombolysis.