Antiplatelet therapy for ischemic heart disease in the elderly.

A vast experience has developed defining an important role for blood platelets in the etiology of atherosclerotic coronary disease. Antiplatelet drugs such as aspirin have major therapeutic applications in various ischemic heart disease syndromes. Areas of proven efficacy for antiplatelet therapy include maintenance of saphenous vein graft patency and prevention of myocardial infarction and death in patients with unstable angina and in survivors of myocardial infarction. Other less-defined applications include primary prevention and use during acute myocardial infarction with and without thrombolysis. The issues of antiplatelet efficacy in women, drug doses, and risk of toxicity need further clarification.