Aspirin Dose and Atherosclerosis in Patients With Metabolic Syndrome

Aspirin reduces risks of heart attacks, strokes, and deaths from cardiovascular causes in
patients who have survived a prior event as well as during an acute heart attack. Aspirin
also prevents a first heart attack.

Low dose aspirin is sufficient to achieve complete inhibition of platelet aggregability, or
stickiness, and this is the mechanism whereby aspirin prevents formation of blood clots.

Our research is designed to explore whether higher doses of aspirin provide additional
benefits on markers of atherosclerosis.

Inclusion Criteria:

- 1. Age 40 to 80 years, inclusive.

2. No previous heart attack or a stroke, or other forms of these diseases.

3. Have at least three of the five characteristics listed below, indicating presence
of metabolic syndrome, as defined by NCEP-III:

1. waist measuring more than 40 inches (for men) or more than 35 inches (for women),

2. high density lipoprotein (HDL) cholesterol levels lower than 40 milligrams per
deciliter (mg/dl) in men or 50 mg/dl in women,

3. triglyceride (TG) levels above 150 mg/dl,

4. blood pressure greater than 130 millimeters of mercury (mmHg) systolic or 85 mmHg
diastolic,

5. fasting blood sugar greater than 110 mg/dl

Exclusion Criteria:

1. Patients taking greater than 81mg aspirin daily.

2. Patients taking anti-platelet drugs such as clopidogrel or non-steroidal
anti-inflammatory drugs (NSAIDs) or anticoagulant drugs such as warfarin, during the
last two weeks.

3. Patients taking any of the following medications for less than 3 months, or who plan
to take them for the first time during the next 3 months: ACE-inhibitors, angiotensin
receptor blockers, calcium channel blockers, or statins.

4. Patients who are currently cigarette smokers.

5. Women patients who are pregnant, planning to become pregnant, nursing a child, or
taking hormone replacement therapy.

6. Patients with any coagulation, bleeding or blood disorders.

7. Patients who are sensitive or allergic to aspirin.

8. Patients with documented history of any gastrointestinal disorders, including bleeding
ulcers.

9. Patients with any evidence of cancer or history of significant cardiovascular disease
(including heart attack, stroke or drop attacks termed transient ischemic attacks
(TIAs), or blockages of the arteries in the legs termed peripheral arterial disease
(PAD)), kidney, liver, lung, blood, or brain disorders.

10. Patients with asthma, rhinitis, or nasal polyps.

11. Patients with any abnormal laboratory value or physical finding that, in the view of
the responsible clinician, may interfere with interpretation of the study results, be
indicative of an underlying disease state, or compromise the safety.

12. Patients with Class IV heart failure.

13. Patients with severe aortic insufficiency, or aortic regurgitation.

14. Patients with hearing loss or tinnitus.

15. Patients with tremors which cause them not to be able to remain motionless for
approximately 30 seconds.