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MI MAY BE LESS SEVERE IN ASPIRIN USERS.

Several studies show that aspirin helps prevent cardiovascular events, particularly in patients with known coronary artery disease, but whether aspirin alters the severity or presentation of these events is unclear. This large multicenter observational study looked at how myocardial infarctions differ between aspirin users and nonusers. Of 2114 patients with documented MI, 332 (16 percent) had been taking aspirin. These patients more commonly had previous infarction, stroke, or angina than the aspirin nonusers, and were less likely than the nonusers to receive thrombolytic therapy for the current infarction. About 65 percent of aspirin users had current non-Q-wave infarctions, as compared with 49 percent of nonusers, and 30 percent of users' infarctions were small, versus 22 percent of nonusers' infarctions. Aspirin use was independently associated with a greater likelihood of non-Q-wave and small infarctions after adjustment for multiple factors, including previous coronary disease, use of other medications before the MI, and use of thrombolytic therapy. Comment: Although this population-based study was not a randomized trial, it hints at yet another benefit of aspirin -- a shift in the pattern of myocardial infarction to one of less severe damage.

— CD Mulrow

Published in Journal Watch General Medicine July 21, 1995

Citation(s):

Col NF et al. Does aspirin consumption affect the presentation or severity of acute myocardial infarction?. Arch Intern Med 1995 Jul 10 155 1386-1389.

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