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[Aspirin in secondary cardiovascular prevention: from clinical studies to daily practice]
1Service de Cardiologie, Centre Hospitalier, Vendôme.
Insights
Aspirin significantly reduces recurrent heart attacks by 30% in secondary prevention. New formulations like calcium carbasalate improve gastrointestinal tolerance, increasing aspirin use for cardiovascular health.
Area of Science:
- Cardiology
- Pharmacology
Context:
- Aspirin is proven effective for acute myocardial infarction and secondary prevention of coronary artery disease.
- It reduces recurrent infarction risk by approximately 30% by inhibiting platelet aggregation and thrombolysis.
Purpose:
- To highlight the established clinical benefits of aspirin in managing coronary artery disease.
- To address the underutilization of aspirin due to gastrointestinal side effects.
- To introduce calcium carbasalate as a well-tolerated alternative.
Summary:
- Aspirin therapy is validated for acute myocardial infarction and secondary prevention, reducing recurrent events.
- Despite consensus on dosage (160-325 mg/day), its use is suboptimal, often due to aspirin's gastrointestinal toxicity.
- Calcium carbasalate, a soluble aspirin complex, offers improved gastrointestinal tolerance and is a promising alternative.
Impact:
- Increased understanding of aspirin's role in modifying coronary artery disease progression.
- Potential for improved patient adherence and outcomes through better-tolerated aspirin formulations.
- Encourages wider adoption of aspirin for secondary cardiovascular prevention.
Abstract:
The clinical benefit of aspirin in coronary insufficiency has been validated in the acute phase of myocardial infarction and in secondary prevention with a reduction of the risk of recurrent infarction of the order of 30%. By interfering with the process of thrombolysis, aspirin modifies the natural history of coronary artery disease by decreasing the frequency and severity of pathological events. Although a relative consensus has been reached concerning the dosages (160 to 325 mg/day), the use of aspirin nevertheless remains very insufficient, sometimes because of the risk of gastrointestinal intolerance related to the gastrotoxicity of aspirin, hence the importance of pharmaceutical forms designed to improve the gastrointestinal tolerance, such as calcium carbasalate (soluble aspirin complex), which appears to be particularly well tolerated.