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GPs buried under trusts' workload dump

New blow for aspirin use in CVD prevention

By Lilian Anekwe

Exclusive: The role of aspirin in the prevention of cardiovascular events has been dealt another blow by the results of a randomised controlled trial by Scottish researchers.

A study published in the Journal of the American Medical Association (JAMA) found that daily aspirin did not reduce vascular events in patients with a low ankle brachial index (ABI).

Researchers screened nearly 30,000 patients aged between 50 and 75 who were free of clinical cardiovascular disease over ten years. 3,350 patients with an ABI less than 0.95 were then given either 100mg aspirin daily or a placebo, and followed-up for a mean of 8.2 years.

ABI screening has been put forward as a way of picking up previously undiagnosed peripheral arterial diseas,e but there was no statistically significant difference between groups in coronary events, strokes or revascularisations, with 13.7 cardiovascular events per 1,000 person-years recorded in the aspirin group compared with 13.3 in the placebo group.

Similarly there was no significant difference in secondary endpoints – angina, intermittent claudication and transient ischaemic attack.

Bleeding was 1.7 times more common in the aspirin group, prompting lead researcher Professor Gerry Fowkes, professor of cardiovascular epidemiology at the University of Edinburgh, to conclude that ‘such adverse effects are of particular concern in the context of screening the healthy population and when the absolute effects of aspirin in reducing major vascular events may be small.'

JAMA, 2010;303(9):841-848.

The evidence for use of aspirin in primary prevention of CVD is weak The evidence for use of aspirin in primary prevention of CVD is weak

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