Atherosclerosis: aspirin may be useful among patients with a prior ischaemic event

  • Clin Cardiol

  • from Antara Ghosh
  • Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • In outpatients with stable atherosclerosis, aspirin use was marginally beneficial only among patients with atherosclerosis with a prior ischaemic event.

Why this matters

  • Although not well studied, aspirin has been assumed to be of benefit and recommended in all forms of atherosclerosis, including those without a prior ischaemic event.

Study design

  • Participants from the Reduction of Atherothrombosis for Continued Health (REACH) registry were followed prospectively for up to 4 y.
  • Patients were divided according to prior ischaemic event (n=21,724) vs stable atherosclerosis, but no prior ischaemic event (n=11,872).
  • Primary outcome was the first occurrence of cardiovascular death, myocardial infarction (MI) or stroke.
  • Funding: None disclosed.

Key results

  • At a median of 41 mo, the risk for occurrence of cardiovascular death, MI or stroke was marginally lower with aspirin users vs non-users (15.2% vs 15.8%; HR, 0.81; P=.06).
  • At a median of 36 mo, aspirin use was not associated with a lower risk for cardiovascular death, MI or stroke in the group without a prior ischaemic event (HR, 1.03; P=.86).

Limitations

  • Lack of benefit of aspirin therapy among the atherosclerosis group reflects insufficient power to detect a difference in outcomes.
  • Outcomes in REACH were not adjudicated.