Acetylsalicylic acid ( ASA ) did not reduce stroke or ‘ all cardiovascular events ’ compared to placebo in primary prevention patients with elevated BP and no prior cardiovascular disease .
To conclude for primary prevention in patients with elevated BP , antiplatelet therapy with ASA can not be recommended since the magnitude of benefit , a reduction in myocardial infa rct ion , is negated by a harm of similar magnitude , an increase in major haemorrhage .
Although elevated systemic blood pressure ( BP ) results in high intravascular pressure , the main complications of hypertension are related to thrombosis rather than haemorrhage .
It therefore seemed plausible that use of antithrombotic therapy may be useful in preventing thrombosis-related complications of elevated BP .
The objectives were to conduct a systematic review of the role of antiplatelet therapy and anticoagulation in patients with BP , to address the following hypotheses : ( i ) antiplatelet agents reduce total deaths and /or major thrombotic events when compared to placebo or other active treatment ; and ( ii ) oral anticoagulants reduce total deaths and /or major thromboembolic events when compared to placebo or other active treatment .
Prediction of 1-year survival after thrombolysis for acute myocardial infarction in the global utilization of streptokinase and TPA for occluded coronary arteries trial.
BACKGROUND When a patient survives thrombolysis for acute myocardial infa rct ion , little information from large studies exists from which to estimate prognosis during follow-up visits . METHODS AND RESULTS Baseline , in-hospital , and later survival data were collected from 41 021 patients enrolled in Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries , a r and omized trial of 4 thrombolytic-heparin regimens with st and ard aspirin and beta-blockade .  Cox proportional hazards models were developed to predict 1-year survival in 30-day survivors ( n=37 869 ) from baseline clinical and ECG factors and in-hospital factors ; a combined model then was developed ( C-index 0.800 ) . The model was simplified into a nomogram to predict individual outcomes ( C-index 0.754 ) . Factors reflecting demographics ( advanced age , lighter weight ) , larger infa rct ions ( higher Killip class , lower blood pressure , faster heart rate , longer QRS duration ) , cardiac risk ( smoking , hypertension , prior cerebrovascular disease ) , and arrhythmia were important predictors of death between 30 days and 1 year . Black race was associated with a substantial increase in risk after considering other factors . Revascularization was associated with reduced risk between 30 days and 1 year . CONCLUSIONS When evaluating a patient who has survived acute infa rct ion treated with thrombolysis  , clinicians can estimate the likelihood of survival from factors easily measured during admission . Although many risk factors clearly relate to age , left ventricular dysfunction , or clinical instability , black race is an unexplained risk factor requiring further examination
Acetylsalicylic acid ( ASA ) did not reduce stroke or ‘ all cardiovascular events ’ compared to placebo in primary prevention patients with elevated BP and no prior cardiovascular disease .
To conclude for primary prevention in patients with elevated BP , antiplatelet therapy with ASA can not be recommended since the magnitude of benefit , a reduction in myocardial infa rct ion , is negated by a harm of similar magnitude , an increase in major haemorrhage .
Although elevated systemic blood pressure ( BP ) results in high intravascular pressure , the main complications of hypertension are related to thrombosis rather than haemorrhage .
It therefore seemed plausible that use of antithrombotic therapy may be useful in preventing thrombosis-related complications of elevated BP .
The objectives were to conduct a systematic review of the role of antiplatelet therapy and anticoagulation in patients with BP , to address the following hypotheses : ( i ) antiplatelet agents reduce total deaths and /or major thrombotic events when compared to placebo or other active treatment ; and ( ii ) oral anticoagulants reduce total deaths and /or major thromboembolic events when compared to placebo or other active treatment .