Chemoprevention Flashcards
Which pathway does Aspirin have the greatest affect on?
COX-1
Aspirin inhibits Prostaglandin H2 production which in turns
decreases Thromboxane and Prostacyclin
What is the role of thromboxane A2?
platelet aggregation (vasoconstriction)
What is the role of prostacyclin?
decrease platelet aggregation (vasodilation)
What effect does aspirin have on platelets and vascular endothelium
permanent effect
and transient effect
Why is there not a long term problem w/ aspirin?
because vascular endothelium adapts and starts to reproduce prostacycins 1-2dys
Aspirin significantly reduced the risk of what in men?
1st MI
When is there a increased risk of clotting due to taking aspirin?
When first taken
What is theory concerning ASA?
if taken on a regular basis, might shift to pro-antiaggregatory system favoring inhibition of platelet aggregation
What kind of study was the Physicians Health Study of 1989?
randomized double blind, placebo controlled trial
Men took what dosage of aspirin in the PHS study?
325mg every other day for 5 yrs
Decrease in MI occurred the greatest in what group?
men > 50 yr
Decrease in MI occurred the smallest in what group?
men < 50yr
ASA did not ?? in men
decrease risk of 2nd MI
In the PHS what did ASA increase the risk of …
Hemorrhagic stroke (but no effect on overall mortality)
What is the most common bleeding disorder seen in ASA?
Hemorrhagic
What is the recommend guideline of ASA for men?
low dose for men w/ hyperlipidemia, HTN
High doses of ASA can cause?
GI ulcers
What dosage of ASA is used in the Women’s Health Study
100mg every other day or placebo for 10 yrs
In the WHS study ASA was shown to..
NOT decrease risk of MI, CVA & cv Death
A decrease risk in CV events in women ??? yr
> over 65yr
ASA did what to the risk of ischemic stroke in WHS
decreased risk of stroke
What was the overall positive effect of ASA in WHS?
decreased stroke no effect on MI
What was the overall positive effect of ASA in PHS?
decreased MI no effect on CVA
What is the recommend guidelines on ASA for women?
women over >65
ASA did not do what in WHS?
reduce the risk of MI, CVA, and CV death
What is the recommended dose for ASA?
81 mg
What dose of aspirin is very effective but has the highest side effect
> 75mg
Taking more aspirin pills will just
increase side effects
Primary prevention trials show that ASA is actually
has LITTLE TO NO additional benefit for prevention of CV events
T/F taking statins works better than aspirin?
TRUE
T/F aspirin should not be used for primary prevention of CV?
TRUE
