'Time is Muscle': Aspirin Taken During Acute Coronary Thrombosis
'Time is Muscle': Aspirin Taken During Acute Coronary Thrombosis
Low-dose aspirin is of value in the long-term management of vascular disease, and the giving of aspirin to patients believed to be experiencing an acute myocardial infarction (AMI) is standard practice for paramedics and doctors in most countries. Given during infarction, aspirin may disaggregate platelet microthrombi and may reduce the size of a developing thrombus. Effects of aspirin other than on platelets have also been suggested and these include an increase in the permeability of a fibrin clot and an enhancement of clot lysis. Animal experiments have also shown a direct effect of aspirin upon the myocardium with a reduction in the incidence of ventricular fibrillation.
Randomised trials have shown that the earlier aspirin is taken by patients with myocardial infarction, the greater the reduction in deaths. We suggest, therefore, that patients known to be at risk of an AMI, including older people, should be advised to carry a few tablets of soluble aspirin at all times, and chew and swallow a tablet immediately, if they experience severe chest pain.
Aspirin, used in vascular disease prophylaxis, is probably the most cost-effective drug available in clinical practice and daily low-dose aspirin is now a standard item in the long-term management of vascular disease. Within a public health context, the provision of aspirin to individuals at increased vascular risk has been judged to be the preventive activity of greatest benefit and at the lowest cost (by far), apart from smoking cessation. Patients with known vascular disease are clearly at increased vascular risk, and a recent US Task Force judged that 'individuals at increased risk' includes males aged over about 45 and females over about 55 years, and the conclusions in two reports based on UK populations are in close agreement.
(Enlarge Image)
In the acute situation, the giving of aspirin to a patient believed to be experiencing an acute myocardial infarction (AMI) is standard practice. In what follows, the evidence of benefit from early aspirin is examined and we consider the possible additional benefits if patients at increased vascular risk, including older people, were advised to carry their own aspirin, and chew and swallow an 'adult' (300 mg) tablet immediately they experience symptoms suggestive of AMI – the aspirin to be taken even as they summon help.
Abstract and Introduction
Abstract
Low-dose aspirin is of value in the long-term management of vascular disease, and the giving of aspirin to patients believed to be experiencing an acute myocardial infarction (AMI) is standard practice for paramedics and doctors in most countries. Given during infarction, aspirin may disaggregate platelet microthrombi and may reduce the size of a developing thrombus. Effects of aspirin other than on platelets have also been suggested and these include an increase in the permeability of a fibrin clot and an enhancement of clot lysis. Animal experiments have also shown a direct effect of aspirin upon the myocardium with a reduction in the incidence of ventricular fibrillation.
Randomised trials have shown that the earlier aspirin is taken by patients with myocardial infarction, the greater the reduction in deaths. We suggest, therefore, that patients known to be at risk of an AMI, including older people, should be advised to carry a few tablets of soluble aspirin at all times, and chew and swallow a tablet immediately, if they experience severe chest pain.
Introduction
Aspirin, used in vascular disease prophylaxis, is probably the most cost-effective drug available in clinical practice and daily low-dose aspirin is now a standard item in the long-term management of vascular disease. Within a public health context, the provision of aspirin to individuals at increased vascular risk has been judged to be the preventive activity of greatest benefit and at the lowest cost (by far), apart from smoking cessation. Patients with known vascular disease are clearly at increased vascular risk, and a recent US Task Force judged that 'individuals at increased risk' includes males aged over about 45 and females over about 55 years, and the conclusions in two reports based on UK populations are in close agreement.
(Enlarge Image)
In the acute situation, the giving of aspirin to a patient believed to be experiencing an acute myocardial infarction (AMI) is standard practice. In what follows, the evidence of benefit from early aspirin is examined and we consider the possible additional benefits if patients at increased vascular risk, including older people, were advised to carry their own aspirin, and chew and swallow an 'adult' (300 mg) tablet immediately they experience symptoms suggestive of AMI – the aspirin to be taken even as they summon help.
Source...