Aspirin has nonplatelet-mediated effects that contribute to its efficacy in the primary and secondary prevention of coronary events. These include antiarrhythmic effects, as shown in animal studies, and antiatherosclerotic effects related to increase in nitric oxide synthesis/activity and reduction in inflammatory mediators. Epidemiological studies have also shown primary antiinflammatory properties. Aspirin is known to inhibit vascular smooth muscle cell proliferation and to produce an endothelial stabilizing effect. Other observed outcomes from the administration of this compound include a modest anticoagulant activity, angiogenesis reduction and a decrease in oxidant stress. We believe that these results complement the antiplatelet effect and make this agent unique in the management of ischemic heart disease.