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Platelets, carotids, and coronaries

Critique on antithrombotic role of antiplatelet agents, exercise, and certain diets
  • Edward R. Eichner
    Correspondence
    Requests for reprints should be addressed to Dr. Edward R. Eichner, Hematology Section, Department of Medicine, University of Oklahoma Health Sciences Center, P.O. Box 26901, Oklahoma City, Oklahoma 73190.
    Footnotes
    Affiliations
    Oklahoma City, Oklahoma USA
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  • Author Footnotes
    1 From the Department of Medicine, University of Oklahoma Health Sciences Center and Oklahoma City Veterans Administration Hospital, Oklahoma City, Oklahoma.
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      Abstract

      “Antiplatelet” drugs and certain life styles seem to have an “antithrombotic” effect that may help protect against stroke and heart attack. This review of the experience with aspirin, dipyridamole, and sulfinpyrazone offers new interpretations of some of the major clinical trials, suggests guidelines for use of antiplatelet drugs, and integrates novel observations on diet and exercise into the “thromboxane-prostacyclin balance” hypothesis. It is argued that the Canadian stroke study showed that aspirin protects men with transient ischemic attacks from coronary death as well as from stroke, that type II errors may have been made in some clinical trials, that aspirin protects women as well as men, that aspirin benefits patients who have had a heart attack, that the effect of aspirin in angina varies with the type of angina, that the dose of aspirin used may not be critical, that guidelines for use of dipyridamole and sulfinpyrazone are still inconclusive, and that exercise and fish oil supplements may be “antithrombotic.”
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