Acetylsalicylic acid in the secondary prevention of cardiovascular complications

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Abstract

The development of symptoms of vascular disease significantly increases the risk of atherothrombotic complications. Despite the emergence of new antiplatelet drugs, for patients with cardiovascular diseases, acetylsalicylic acid (ASA) remains the basic antiplatelet agent. With secondary prophylaxis, the benefits of low (75-100 mg) and medium (150-325 mg) doses of ASA have been convincingly proven. A comparison of the antiplatelet efficacy of low doses of different forms of ASA showed that the enteric coating slows the release and absorption of ASA. Unlike conventional ASA, after the first dose of the enteric form, the degree of acetylation of cyclooxygenase-1 does not reach the maximum value. However, upon repeated daily intake, the acetylation of platelet cyclooxygenase cumulates and leads to a sufficient inhibition of its activity and inhibition of platelet function by the 6th day. The problem of prolonged use of ASA for the prevention of cardiovascular events is an increase in the frequency of gastrotoxic side effects and an increased risk of major bleeding. Most of the studies conducted did not reveal a significant reduction in the risk of bleeding from the upper gastrointestinal tract when using special forms of ASA. The main role in the development of the toxic effect of ASA on the mucous membrane of the upper gastrointestinal tract is assigned to systemic mechanisms.

About the authors

Andrei A. Kirichenko

Russian Medical Academy of Continuous Professional Education

Email: andrey.apollonovich@yandex.ru
д-р мед. наук, проф., зав. каф. терапии Moscow, Russia

E. Iu Ebzeeva

Russian Medical Academy of Continuous Professional Education

Email: veta-veta67@mail.ru
Cand. Sci. (Med.) Moscow, Russia

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