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MI - ANTIPLATELET AGENTS REDUCE RISK OF DEATH

Clinical Bottom Line:
ASA started immediately and continued for 1 month decreases vascular events and mortality.
Appraised by: S. Straus

Question: In a pt with suspected MI, does ASA given immediately decrease mortality?

Search Terms: myocardial infarction, antiplatelet agents, Best Evidence

The Study:
Systematic overview of randomised trials comparing prophylactic therapy with no therapy or comparing 2 or more antiplatelet agents
145 trials looking at 70000 high risk pts (previous MI, current MI) and 30000 low risk pts

The Evidence:
OutcomesTime to Follow-upNNT
Mortality1 month26
Death+MI+stroke2 yrs25

Comments:

  1. serious bleeding rare
  2. dose of ASA - 300 mg immediately followed by 75-150 mg per day

Reference:

  1. Antiplatelet Trialists' Collaboration. Collaborative overview of randomised trials of antiplatelet therapy 1: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ 1994;308:83-108.

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