- 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.
- 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.
- 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).
- 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.