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      Infarct Size Is Reduced and the Frequency of Non-Q-Wave Myocardial Infarctions Is Increased in Patients Using Aspirin at the Onset of Symptoms



      S. Karger AG

      Aspirin, Infarct size, Non-Q-wave infarcts, Thrombolytic treatment

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          In an observational study we wanted to investigate whether ongoing use of aspirin in a cohort of 753 patients with acute myocardial infarction was able to (1) reduce infarct size as assessed by peak creatine kinase and lactate dehydrogenase, (2) increase the number of non-Q-wave myocardial infarctions, and (3) to what extent thrombolytic treatment at admission could modify these outcomes. We used an exposed (aspirin+)/nonexposed (aspirin–) cohort design, adjusting for the effects of confounders (age, previous coronary heart disease, current smoking, and the prior use of β-blockers and long-acting nitrates) as well as for the modifying effect of thrombolytic treatment. Crude and adjusted effects showed that aspirin reduced infarct size only in patients not receiving thrombolytic treatment at admission to hospital (n = 411 patients). In analyzing the occurrence of non-Q-wave versus Q-wave myocardial infarctions, the outcome was dichotomized. Crude odds ratio (OR) for developing a non-Q-wave myocardial infarction in aspirin users was 2.63 (2p < 0.001), in the restricted cohort of patients receiving thrombolytic treatment, OR was 3.46 (2p = 0.002), whereas in those not receiving such treatment, OR was 1.81 (2p = 0.007). Adjusting for the effects of confounders, retained aspirin was an independent predictor of non-Q-wave myocardial infarctions, an effect that was probably increased (from 51 to 128%) in those who received thrombolytic treatment. Thus, aspirin seems to produce a shift to less severe manifestations of myocardial infarction, an effect that was increased in patients given thrombolytic treatment at admission to hospital.

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          Most cited references 2

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          Aspirin as an antiplatelet drug.

           C Patrono (1994)
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            Does aspirin consumption affect the presentation or severity of acute myocardial infarction?

             N Col,  J Yarzbski,  J Gore (1995)
            While consumption of aspirin has been shown to decrease the occurrence of nonfatal cardiac events, the majority of studies have not demonstrated any impact of aspirin intake on cardiovascular mortality. The present population-based study explores the possibility that aspirin consumption affects the presentation and severity of acute myocardial infarction (AMI), and hence the likelihood of clinical detection.

              Author and article information

              S. Karger AG
              August 1999
              06 August 1999
              : 91
              : 2
              : 119-126
              Research Forum, Epidemiology Section, Department of Cardiology, Ullevål University Hospital, and Department of Pharmacotherapeutics, University of Oslo, Norway
              6891 Cardiology 1999;91:119–126
              © 1999 S. Karger AG, Basel

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              Page count
              Tables: 9, References: 39, Pages: 8
              Coronary Care


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