Debabrata Mukherjee, MD, MS
In patients with peripheral artery disease (PAD), does aspirin reduce cardiovascular (CV) events?
Included studies compared aspirin with placebo or control for reducing CV events in patients with PAD. Outcomes were a composite endpoint of nonfatal myocardial infarction (MI), nonfatal stroke, and CV mortality; individual components of the composite endpoint; all-cause mortality; and major bleeding. The meta-analysis had 88% power to detect a 25% reduction in the composite endpoint in the aspirin group.
MEDLINE, EMBASE/Excerpta Medica, Cochrane Central Register of Controlled Trials, Science Citation Index, Web of Science, Social Science Citation Index (1966 to 2008), reference lists, major scientific meetings, and supplemental index of the Antithrombotic Trialists’ Collaboration were searched, and experts were contacted for randomized controlled trials (RCTs). 18 RCTs (n = 5269) met the selection criteria. 12 RCTs had Jadad scores of 2 to 5.
Meta-analysis showed that aspirin did not differ from placebo or control for the composite endpoint, nonfatal MI, CV mortality, all-cause mortality, or major bleeding (Table). A secondary analysis showed that aspirin reduced nonfatal stroke (Table).
Aspirin does not reduce cardiovascular events but may reduce nonfatal stroke in patients with peripheral artery disease.
Aspirin vs placebo or control for cardiovascular (CV) outcomes in peripheral artery disease*
*MI = myocardial infarction; other abbreviations defined in Glossary. Weighted event rates, RRR, RRI, NNT, NNH, and CI calculated from control event rates and relative risks in article using a random-effects model.
†Nonfatal MI, nonfatal stroke, and CV death.
Debabrata Mukherjee. Review: Aspirin does not reduce CV events but may reduce nonfatal stroke in peripheral artery disease. Ann Intern Med. 2009;151:JC3–5. doi: 10.7326/0003-4819-151-6-200909150-02005
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Published: Ann Intern Med. 2009;151(6):JC3-5.
Cardiology, Neurology, Prevention/Screening, Stroke.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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