[Coronary disease: benefits of aspirin. What dose for which disease?].

Thrombotic occlusion is one of the chief complications of coronary atherosclerosis. The search for an effective method to prevent coronary thrombosis has thus been an active research area for several years. The anti-thrombotic drug most studied during the past twenty years has been aspirin. Many studies have shown the usefulness of aspirin in the secondary prevention of recurrences of cardiovascular disease: during the acute phase of myocardial infarction, post-infarction, in unstable angina, and following angioplasty or aortocoronary bypass. While the benefits of this platelet anti-aggregant are now unanimously recognised, since aspirin reduces by approximately 25% the risk of a further coronary event after a first episode, the question today concerns the optimal dose to be used in each pathological context. Analysis of data from major clinical trials of aspirin as secondary prevention reveals the usefulness of a daily dose of aspirin of between 160 and 300 mg, with many studies undertaken at the dose of 300 mg/day. In the special case of the acute phase of myocardial infarction, the dose of 160 mg/day appears most suitable, as shown by the results of the vast ISIS II study.