Evidence supporting the use of: Acetylsalicylic acid
For the health condition: Angina

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Acetylsalicylic Acid (Aspirin) in the Management of Angina

Acetylsalicylic acid, commonly known as aspirin, is widely used in the management of angina, particularly in the context of stable angina and acute coronary syndromes (ACS), including unstable angina. The scientific rationale for its use is based on its antiplatelet properties. Aspirin irreversibly inhibits cyclooxygenase-1 (COX-1), leading to decreased synthesis of thromboxane A2, a promoter of platelet aggregation. By reducing platelet aggregation, aspirin lowers the risk of thrombus (clot) formation within coronary arteries, which is a primary mechanism behind myocardial infarction (heart attack) and the progression of angina to more severe forms of coronary artery disease.

Multiple large-scale randomized controlled trials and meta-analyses (such as the ISIS-2, Antithrombotic Trialists’ Collaboration, and others) have demonstrated that aspirin reduces the risk of major vascular events, including myocardial infarction and stroke, in patients with known coronary artery disease. In stable angina, aspirin is recommended by major cardiology guidelines (e.g., American Heart Association, European Society of Cardiology) to prevent future cardiovascular events. In unstable angina, aspirin is a cornerstone therapy because of its rapid and significant reduction in mortality and morbidity when administered early.

While aspirin does not directly relieve anginal pain, its role is preventive—reducing the risk of heart attacks and death in patients with angina. Its use is therefore scientifically validated and guideline-recommended for the management and secondary prevention in angina patients.

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