Example: ASA in Acute MI
Best Grade of Evidence: A, M
Population: All adult patients with symptoms of AMI.
Purpose:1. To decrease 30 day mortality by 29%. NNT=25.
2. To decrease 2 year mortality by 24%. NNT=18 if SK used.
Exclusion Criteria:1. Aspirin allergy OR
2. Known active CNS bleeding OR
3. Known active peptic ulcer disease
Recommendation: If patient presents with symptoms of AMI administer ASA per protocol immediately and every other day there after. Dose: 160-325mg X 1 chewable or per rectum.
Expected Harms: Minimal increase in UGI bleed at doses of 325mg/day or less.
References: ISIS-2 collaborative group. Lancet 1988;318:349-360 (Grade A)
Anti platelet Trialists Group. BMJ 1994;308:81-106 (Grade M)