ACETYLSALICYLIC ACID IN CARDIOLOGY: BENEFITS, RISKS, AND CLINICAL INDICATIONS

Acetylsalicylic acid (ASA) is an antiplatelet agent widely used in cardiology and has an essential role in the prevention and treatment of cardiovascular diseases. By irreversibly inhibiting cyclooxygenase-1 (COX-1), ASA reduces platelet aggregation and the risk of thrombotic events, being recommended in the secondary prevention of myocardial infarction, stroke, and peripheral arterial disease. It is also a central element in the treatment of acute coronary syndromes, administered in combination with other antiplatelet agents. However, its use is not without risks, the main adverse effects being gastrointestinal and intracranial hemorrhages. In primary prevention, the benefits are questionable, requiring a careful evaluation of the risk-benefit ratio. Current research is exploring strategies for optimizing the administration of ASA, including dose adjustment, intermittent administration, and identifying biomarkers that allow for personalized use. The development of safer alternatives and innovative formulations could improve the safety profile of ASA in the future. Thus, individualization of treatment remains essential to maximize efficiency and reduce associated risks.