Abstract
Is anti-platelet treatment indicated in primary prevention? Thrombosis complications of atherosclerosis are the cause of a pandemic of different cardiovascular diseases in the industrialised world. Since the end of the 1980?s there has been a series of studies monitoring the effect of anti-platelet treatment using acetylsalicylic acid (ASA) as part of primary prevention.
Almost one hundred thousand probands have been included in these controlled studies. A composite analysis of the results shows that the treatment is effective in the prevention of acute myocardial infarction, finding a clinically and statistically significant reduction in incidence of around one-third.
Undesirable effects accompanying the administration of ASA were bleeding, in particular significant bleeding into the digestive tract. This was recorded in 1?2% of those treated.
Treatment with lower dosages of ASA should therefore be indicated in primary prevention only for those probands with a higher risk of coronary incident, i.e. p