Aspirin Therapy for Cardiovascular Disease Prevention

Introduction to Aspirin Therapy

The American Heart Association recommends aspirin 75-100 mg once daily for blood clot prevention in most cardiovascular and atherosclerotic conditions, as this dose provides equivalent efficacy to higher doses with significantly fewer bleeding complications 1, 2

The American College of Cardiology recommends starting aspirin 75-162 mg daily and continuing indefinitely in all patients with coronary artery disease unless contraindicated 3, 1
For acute coronary syndromes, the American College of Cardiology recommends giving non-enteric-coated, chewable aspirin 162-325 mg as a loading dose, then maintaining on 81-325 mg daily 4
The American Heart Association recommends using aspirin 75-325 mg daily for symptomatic peripheral artery disease of the lower extremity 1

The American College of Cardiology recommends combining aspirin 81 mg daily with a P2Y12 inhibitor (clopidogrel 75 mg, prasugrel 10 mg, or ticagrelor 90 mg twice daily) for at least 12 months after acute coronary syndrome with stent placement 1, 4
The American Heart Association recommends using low-dose aspirin 75-81 mg daily with target INR 2.0-2.5 when warfarin is indicated (atrial fibrillation, left ventricular thrombus, prosthetic valve) 3, 1

The American College of Cardiology recommends avoiding doses >100 mg for chronic prevention unless specifically indicated, as this increases bleeding without improving efficacy 2
The Mayo Clinic recommends avoiding concurrent NSAID use or separating administration timing to preserve aspirin efficacy 8