Cooper Clinic Aspirin Recommendations

1. History of coronary events or interventions: uncoated ASA 325 mg daily

2. History of recurrent coronary events or interventions on aspirin: uncoated ASA 81 mg plus clopidogrel (Plavix) 75 mg daily

3. History of TIA on no therapy: uncoated ASA 325 mg daily

4. History of TIA on aspirin: clopidogrel (Plavix) 75mg daily

5. History of asymptomatic peripheral vascular disease or diabetes mellitus: uncoated ASA 81-325 mg daily

6. History of symptomatic peripheral vascular disease: clopidogrel (Plavix) 75 mg daily, with or without uncoated ASA 81 mg daily (case specific)

7. Multiple risk factors for CAD: uncoated ASA 81-325 mg daily

8. EBT coronary calcium alone: uncoated ASA 81-325 mg daily

9. Low risk for CAD (no risk factors or Framingham 10 year risk less than 6 percent): no ASA

10. Uncontrolled hypertension (SBP > 160 mm): no ASA until BP is controlled

11. History of significant ASA contraindication (intracranial or GI hemorrhage nasal polyps, ASA allergy, etc.): no ASA, unless for a strong indication with consideration of the risk: benefit assessment

If uncoated ASA 325 mg is not tolerated, recommend taking half the dosage. If uncoated ASA 162 mg is not tolerated, recommend uncoated ASA 81 mg. Enteric coating has not been shown to provide protection from GI bleeding with aspirin, but has been shown to increase the likelihood for aspirin resistance.