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AAC: Low-Dose Aspirin May Be Best After Angioplasty

The long-term risk of bleeding lower in patients taking less than 200 mg of aspirin

TUESDAY, March 27 (HealthDay News) -- Low-dose aspirin works as well as high-dose aspirin to prevent cardiac events in patients with non-ST elevation acute coronary syndromes who have undergone percutaneous coronary intervention, and involves a lower risk of major bleeding months later, according to research presented this week at the American College of Cardiology's meeting in New Orleans.

Sanjit S. Jolly, M.D., of Hamilton Health Sciences in Ontario, Canada, and colleagues compared cardiovascular deaths, myocardial infarctions, stroke and major bleeding in 2,658 patients who had undergone percutaneous coronary intervention. Patients took low-dose (100 mg or less), intermediate (101 to 199 mg) or high-dose (200 mg or more) aspirin.

The researchers found that after one month and eight months, cardiovascular death rates, myocardial infarction rates and stroke incidence were similar in all three groups. But 3.9 percent of patients on high-dose aspirin had major bleeding at eight months, compared to 1.5 percent and 1.9 percent of those on intermediate and low doses, respectively. There was no difference between the groups at three months.

"In this large observational analysis of patients with acute coronary syndromes undergoing percutaneous coronary intervention, low-dose aspirin appeared to be as effective as high-dose aspirin in preventing recurrent cardiac events with no significant differences in bleeding within 30 days," the authors write. "Longer-term treatment with high-dose aspirin demonstrated a similar efficacy benefit but significantly higher bleeding when compared with low-dose aspirin."

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