HealthDay News — For patients with established atherosclerotic cardiovascular disease, there is no significant difference in cardiovascular events or major bleeding for those receiving 81mg or 325mg of aspirin daily, according to a study published online May 15 in the New England Journal of Medicine to coincide with the annual meeting of the American College of Cardiology, held virtually from May 15 to 17.

W. Schuyler Jones, MD, from the Duke Clinical Research Institute in Durham, North Carolina, and colleagues randomly assigned patients with established atherosclerotic cardiovascular disease to a strategy of 81 or 325mg of aspirin/day using an open-label, pragmatic design. Overall, 15,076 patients were followed for a median of 26.2 months.

The researchers found that the composite of death, hospitalization for myocardial infarction, or hospitalization for stroke occurred in an estimated 7.28 and 7.51% of patients in the 81mg and 325mg groups, respectively (hazard ratio, 1.02; 95% confidence interval, 0.91 to 1.14). Hospitalization for major bleeding occurred in an estimated 0.63 and 0.60% of patients in the 81mg and 325mg groups, respectively (hazard ratio, 1.18; 95% confidence interval, 0.79 to 1.77). The incidence of dose switching was higher for patients assigned to 325mg vs those assigned to 81mg (41.6 vs 7.1%), and they had fewer median days of exposure to the assigned dose (434 vs 650 days).

“A strategy of 81mg of daily aspirin had similar effectiveness as a strategy of 325mg in patients with established atherosclerotic cardiovascular disease, and long-term adherence was better with the 81mg dosing strategy,” the authors write.


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Several authors disclosed financial ties to the pharmaceutical and medical technology industries.

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