HIGH-DOSE ASPIRIN AGGRAVATES PRINZMETAL'S ANGINA 4 patients with Prinzmetal's variant angina had chest pain associated with ST segment elevation occurring at night and in the early morning at least 5 times per week. All medications except glyceryl trinitrate (nitroglycerin) were withdrawn before the study. Aspirin 4 g/day in 2 divided doses with antacids was given orally on 2 successive days. Constant ECG monitoring revealed that the frequency of the attacks of variant angina was aggravated in all 4 patients. With aspirin the attacks even appeared during the daytime whereas they did not before. Afternoon exercise stress testing was negative without aspirin but was positive with aspirin in the 3 patients tested. It is thought that large aspirin doses inhibit the synthesis of prostaglandin 1 2 , which is necessary to cause coronary vasodilation. Coronary artery spasm can therefore be aggravated in cases of Prinzmetal's variant angina. Miwa, K. et al.: American Heart Journal 105: 351 (Feb 1983) 0156-2703/83/0312-0013/0$01.00/0 © ADIS Press INPHARMA 12 Mar 1983 13

HIGH-DOSE ASPIRIN AGGRAVATES PRINZMETAL’S ANGINA

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HIGH-DOSE ASPIRIN AGGRAVATES PRINZMETAL'S ANGINA

4 patients with Prinzmetal's variant angina had chest pain associated with ST segment elevation occurring at night andin the early morning at least 5 times per week. All medications except glyceryl trinitrate (nitroglycerin) were withdrawnbefore the study. Aspirin 4 g/day in 2 divided doses with antacids was given orally on 2 successive days.Constant ECG monitoring revealed that the frequency of the attacks of variant angina was aggravated in all 4 patients.With aspirin the attacks even appeared during the daytime whereas they did not before. Afternoon exercise stresstesting was negative without aspirin but was positive with aspirin in the 3 patients tested.It is thought that large aspirin doses inhibit the synthesis of prostaglandin 12, which is necessary to cause coronaryvasodilation. Coronary artery spasm can therefore be aggravated in cases of Prinzmetal's variant angina.Miwa, K. et al.: American Heart Journal 105: 351 (Feb 1983)

0156-2703/83/0312-0013/0$01.00/0 © ADIS Press INPHARMA 12 Mar 1983 13