Prehospital administration of aspirin in patients with unstable angina and acute myocardial infarction

Eisenberg, Mara

doi:10.1001/archinte.156.14.1506

Cited by 6 publications

(3 citation statements)

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“…Aspirin reduces mortality by 23%1 by mechanisms that make its delivery time sensitive 4. The mortality benefit of aspirin administered early in the care of a patient with myocardial infarction makes the prehospital administration of aspirin standard of care in most Emergency Medical Service (EMS) systems 4–7…”

Section: Introductionmentioning

confidence: 99%

Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database

2015

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Section: Introductionmentioning

confidence: 99%

Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database

2015

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“…Several studies have suggested improved outcomes with earlier aspirin administration for patients with acute myocardial infarction. 15–17 …”

Section: Discussionmentioning

confidence: 99%

Comparison of Three Aspirin Formulations in Human Volunteers

Nordt¹,

Clark²,

Castillo³

et al. 2011

WestJEM

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IntroductionThe treatment of acute coronary syndrome (ACS) includes the administration of aspirin. Current guidelines recommend chewing aspirin tablets to increase absorption. While this is intuitive, there are scant data supporting this recommendation. The purpose of this study is to assess which of 3 different aspirin formulations is most rapidly absorbed after ingestion.MethodsA prospective, open-label, 3-way crossover volunteer study at a tertiary university medical center with human subjects 18 years or older. Fasted subjects were randomly assigned to receive aspirin 1,950 mg as (1) solid aspirin tablets swallowed whole, (2) solid aspirin tablet chewed then swallowed, or (3) a chewable aspirin formulation chewed and swallowed. Serum salicylate measurements were obtained over a period of 180 minutes. Pharmacokinetic parameters were determined.ResultsThirteen males and 1 female completed all 3 arms of study. Peak serum salicylate concentrations were seen at 180 minutes in all groups. Mean peaks were 10.4, 11.3, and 12.2 mg/dL in groups 1, 2, and 3, respectively. Mean area under the time concentration was 1,153, 1,401, and 1,743 mg-min/dL in groups 1, 2, and 3, respectively. No measurable salicylate concentrations were seen in 6 subjects in group 1 at 60 minutes as compared to 1 subject in group 2. All subjects in group 3 had measurable levels at 45 minutes. There were no adverse effects in any of the subjects during the study period.ConclusionOur data demonstrate that the chewable aspirin formulation achieved the most rapid rate of absorption. In addition, the chewable formulation absorption was more complete than the other formulations at 180 minutes. These data suggest that in the treatment of ACS, a chewable aspirin formulation may be preferable to solid tablet aspirin, either chewed or swallowed.

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“…Gegenwärtige Therapierichtlinien empfehlen die kombinierte Behandlung mit unfraktioniertem Heparin und Aspirin für die Behandlung von Patienten mit akuten Koronarsyndromen [67][68][69]. Die maximale Dauer der Behandlung mit unfraktioniertem Heparin über den Perfusor sollte 48 Stunden nicht überschreiten, zumal durch eine längere Behandlung ein höheres Risiko für das Auftreten von Tod oder Myokardinfarkt resultieren kann [70].…”

Section: Unfraktioniertes Heparinunclassified

Akute Koronarsyndrome – ein Update Teil I: Pathogenese und medikamentöse Therapie

Auer¹,

Berent²,

Maurer³

et al. 2001

Herz

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Multiple huge clinical trials confirmed that aspirin reduces the risk of death from cardiac causes and fatal and non-fatal myocardial infarction by about 50-70% in patients presenting with unstable angina. Ticlopidine may be substituted for aspirin in patients with hypersensitivity to aspirin or gastrointestinal intolerance. Clopidogrel acts similarly to ticlopidin but has fewer side effects than ticlopidine and has not been reported to cause neutropenia. High-risk patients with refractory unstable angina and elevated troponin levels may have substantial benefit of glycoptotein (GP) IIb/IIIa inhibition. Current practice guidelines support the use of the combination of unfractionated heparin and aspirin for the treatment of unstable angina. Clinical studies have demonstrated that the incidence of the composite end point of death, myocardial infarction, or recurrent angina was lower with enoxaparin than with unfractionated heparin. Beta-blockers, nitrates, and calcium-channel blockers are useful for antiischemic therapy in patients with acute coronary syndromes.

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Prehospital administration of aspirin in patients with unstable angina and acute myocardial infarction

Cited by 6 publications

References 0 publications

Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database

Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database

Comparison of Three Aspirin Formulations in Human Volunteers

Akute Koronarsyndrome – ein Update Teil I: Pathogenese und medikamentöse Therapie

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