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Item #9

Enteric-Coated Aspirin and Stroke Prevention – Does it Work?

Enteric-coated aspirin doesn't inhibit platelets as well as plain aspirin and may not work for preventing cardiovascular disease.

That, from the results of a small study. It's speculated that enteric-coated aspirin might not be absorbed as well as plain aspirin in some patients.  This new info is questionable. Researchers only measured platelet aggregation and not long-term outcomes.

This is more than overshadowed by big studies that show positive cardiovascular outcomes for enteric-coated aspirin.

EC aspirin does not have as rapid an effect on platelet function as immediate-release tablets. But chronic use of 80 mg of EC aspirin has led to greater than 90% inhibition of platelet cyclooxygenase.¹⁰ The weight of the evidence suggests that EC aspirin exerts antiplatelet effects.

It is too soon to suggest that patients stop using EC aspirin. More studies will be needed to more fully elucidate the most effective dose ranges to use, and whether or not the enteric coating has an impact on clinical outcomes.

Continue to tell your patients that EITHER enteric-coated or plain aspirin can help reduce the risk of heart attacks and strokes.

Albers GW, Amarenco P, Easton JD, et al. Antithrombotic and thrombolytic therapy for ischemic stroke. Chest 2001:119 :300S-320S.  Algra A, van Gijn J. Aspirin at any dose above 30 mg offers only modest protection after cerebral ischaemia. J Neurol Neurosurg Psychiatry 1996;60:197-9.

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