Is the use of aspirin contraindicated for primary prevention of heart disease in a patient with stable idiopathic thrombocytopenia whose platelet count has been in the 90,000/µL range for at least two years?
—Katherine McClanahan, DO, Circleville, Ohio

Low-dose aspirin (81 mg) should not pose a problem at a platelet count of 90,000. A count <50,000 is more troublesome; I would probably not consider aspirin in such a patient at all unless he or she had known CAD (i.e., secondary prevention)—and only after consultation with a hematologist.
—Peter F. Cohn, MD (120-4)