• Many well conducted studies have failed to demonstrate additional benefit of high dose ASA (>100 mg/day) for secondary vascular prevention
• However, high dose ASA has been clearly demonstrated to increase the risk of bleeding over low dose
• When used in combination with ticagrelor, there is some suggestion that high dose ASA may reduce efficacy in secondary prevention
• Overall, both short-term and long-term studies suggest that low-dose ASA (81 mg/day in Canada) is optimal following ACS and PCI