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Aspirin’s benefits in helping to prevent atherothrombotic events are ascribed to its antiplatelet effects — specifically, irreversible inhibition of platelet cyclooxygenase-1 (COX-1). To determine the optimal dosage of aspirin with regard to efficacy and safety, researchers conducted a systematic review of clinical trials, meta-analyses, and review articles published through February 2007.
In eight prospective trials involving nearly 10,000 patients, cardiovascular and cerebrovascular outcomes did not differ between patients who took lower doses of aspirin (50–150 mg/day) and those who took higher doses (325–500 mg/day). However, higher dosages were associated with increased risk for hemorrhage, especially gastrointestinal bleeding, compared…