Paper I
2023 March (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Low dose Aspirin in prophylaxis of myocardial infarction

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Answer

Low-dose aspirin (75–150 mg/day) irreversibly acetylates and inhibits platelet cyclooxygenase-1, blocking thromboxane A2 synthesis for the entire lifespan of the platelet (since platelets cannot synthesize new enzyme). At this low dose, the effect on vascular endothelial COX-mediated prostacyclin (which opposes platelet aggregation) is comparatively spared, giving a net antiplatelet, antithrombotic effect that reduces the risk of coronary thrombosis/reinfarction — the rationale for its use in myocardial infarction prophylaxis.

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