LONG-TERM ASPIRIN IN THE PREVENTION OF CARDIOVASCULAR DISORDERS - RECENT DEVELOPMENTS AND VARIATIONS ON A THEME

Aspirin should be considered to have established efficacy as treatment for the long term prevention of cardiovascular events. However, no controlled studies of aspirin administration were extended beyond 5 years, and its use for a longer period is consequently empiric. Presently, its risk-benefit profile supports its indefinite use in high risk patients, but not in the healthy population. Alternative formulations of aspirin, drug combination strategies as well as new, more potent antithrombotic agents, such as orally bioavailable thrombin inhibitors and glycoprotein IIb/IIIa antagonists, are under investigation. These strategies will probably widen the indications for long term platelet inhibition. Results achieved with the intravenously administered monoclonal antibody abciximab, have demonstrated that the efficacy of IIb/IIIa antagonists is additive to that of aspirin.15 Oral IIb/III antagonists have already been shown to induce dose-dependent inhibition of platelet aggregation for an extended period of time53 and are currently in clinical development. Long term treatment with these compounds might be beneficial in indications which aspirin lacks efficacy, such as in the prevention of late thrombotic events and/or restenosis following coronary angioplasty. © 1995, Adis International Limited. All rights reserved.