Who needs antiplatelet therapy?

A series of overviews or meta-analyses of randomized clinical trials prepared by the Antiplatelet Trialists' Collaboration were published in the British Medical Journal in January 1994. They demonstrated that prolonged courses of medium-dose aspirin were very effective at preventing both fatal and non-fatal myocardial infarction and stroke in patients at high risk of occlusive vascular disease. The aim of this review is to provide the general practitioner with a practical guide to the use of aspirin in patients at high and low risk of occlusive vascular disease and to discuss appropriate dosages and contraindications to treatment in the light of all the recent evidence.