"Comparative Effectiveness of Aspirin Dosing in Cardiovascular Disease
Abstract
BACKGROUND
The appropriate dose of aspirin to lower the risk of death, myocardial infarction, and stroke and to minimize major bleeding in patients with established atherosclerotic cardiovascular disease is a subject of controversy.
METHODS
Using an open-label, pragmatic design, we randomly assigned patients with established atherosclerotic cardiovascular disease to a strategy of 81 mg or 325 mg of aspirin per day. The primary effectiveness outcome was a composite of death from any cause, hospitalization for myocardial infarction, or hospitalization for stroke, assessed in a time-to-event analysis. The primary safety outcome was hospitalization for major bleeding, also assessed in a time-to-event analysis.
RESULTS
A total of 15,076 patients were followed for a median of 26.2 months (interquartile range [IQR], 19.0 to 34.9). Before randomization, 13,537 (96.0% of those with available information on previous aspirin use) were already taking aspirin, and 85.3% of these patients were previously taking 81 mg of daily aspirin. Death, hospitalization for myocardial infarction, or hospitalization for stroke occurred in 590 patients (estimated percentage, 7.28%) in the 81-mg group and 569 patients (estimated percentage, 7.51%) in the 325-mg group (hazard ratio, 1.02; 95% confidence interval [CI], 0.91 to 1.14). Hospitalization for major bleeding occurred in 53 patients (estimated percentage, 0.63%) in the 81-mg group and 44 patients (estimated percentage, 0.60%) in the 325-mg group (hazard ratio, 1.18; 95% CI, 0.79 to 1.77). Patients assigned to 325 mg had a higher incidence of dose switching than those assigned to 81 mg (41.6% vs. 7.1%) and fewer median days of exposure to the assigned dose (434 days [IQR, 139 to 737] vs. 650 days [IQR, 415 to 922]).
CONCLUSIONS
In this pragmatic trial involving patients with established cardiovascular disease, there was substantial dose switching to 81 mg of daily aspirin and no significant differences in cardiovascular events or major bleeding between patients assigned to 81 mg and those assigned to 325 mg of aspirin daily."
The above words taken from The New England Journal of Medicine here
h/t Steve Parker M.D. Diabetic Mediterranean Blog here
IMPORTANT
All the best Jan
26 comments:
...that is a question for my doctor!
Thanks for sharing.
In my eyes less is almost always more on the medication front. But yes, I do listen to my doctor.
I have never taken aspirin before and hope I don't have to in future either!
I take half aspirin before bed time.
Coffee is on and stay safe
Siempre hay que tener cuidados con la medicina. Te mando un beso
Interesting read regarding Aspirin.
I am not allowed to have aspirin at all because of other conditions. Have a great week, Valerie
Interesting information, I have never taken an “aspirin a day” to keep the doctor away!!
My dad was diagnosed aspirin for heart problems but they think that taking it regularly contributed to a duodenal ulcer which nearly killed him so he was told to stop taking it. You hear so much contradictory advice about medicines that you don't know what's best.
Um artigo muito interessante e esclarecedor.
Um abraço e continuação de uma boa semana.
Andarilhar
Dedais de Francisco e Idalisa
O prazer dos livros
Interesting read.
Important to note. Asprin can be really dangerous.
A very important and informative article, thank you!
Thank you for sharing this information. Something to ponder. Have a beautiful day.
Very good post. Have a nice day today.
Hi Jan, Wow, this was an especially interesting post to me. I'm a survivor, of sorts. Had triple bypass open heart surgery in 2010 and have done well since. My cardiologist has me on 81mg asprin daily. It makes me feel good to know it apparently works as well as the larger dose. Thanks for posting this. Hope all is well with you and Eddie. Best regards from Seattle. John
Important information
Thanks for this I must remember to check with my doctor re. why am I supposed to take this when I have a great heart? I also have Type 1 diabetes, but still nothing wrong with my heart. Thanks for this reminder.
I rarely use Aspirin.
Interesting question, thank you!
What an interesting post.xxx
Very interesting! Thank you Jan! Big Hugs!
Nunca tomo aspirina, por el momento. Un beso.
if you take aspirin for headache you can many times just dring a glas or two of water. Many times you just are low on water. :)
here we use paracetamol which is replaced by panadol now mostly to release light fever or headache ,i used to take it a lot after my second child due to light feverish feeling because of tiredness ,now though i lessened the use of it
thank you for informative post always friend
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