| Abstract | AIMS: In the setting of percutaneous coronary intervention (PCI), due to a paucity of data, the optimal dose of aspirin is uncertain. We evaluated the safety of different doses of aspirin after PCI. METHODS AND RESULTS: In the PCI-CURE study, 2658 patients with acute coronary syndromes undergoing PCI were stratified into three aspirin dose groups >/=200 mg (high, n = 1064), 101-199 mg (moderate, n = 538), and </=100 mg (low, n = 1056). For efficacy, the moderate- (7.4%) and high-dose groups (8.6%) had similar rates of cardiovascular death, myocardial infarction, or stroke compared with the low-dose group (7.1%). For safety, major bleeding was increased with high-dose aspirin [3.9, 1.5, and 1.9% in the high-, moderate-, and low-dose groups; hazard ratio (HR) of high vs. low dose 2.05 (95% CI 1.20-3.50, P = 0.009]. The net adverse clinical events (death, MI, stroke, major bleeding) favoured low-over high-dose aspirin (8.4 vs. 11.0%, HR 1.31, 95% CI 1.00-1.73 P = 0.056). CONCLUSION: In this large observational analysis of patients undergoing PCI, low-dose aspirin appeared to be as effective as higher doses in preventing ischaemic events but was also associated with a lower rate of major bleeding and an improved net efficacy to safety balance. |
| Authors | Sanjit S Jolly, Janice Pogue, Kimberly Haladyn, Ron J G Peters, Keith A A Fox, Alvaro Avezum, Bernard J Gersh, Hans Jurgen Rupprecht, Salim Yusuf, Shamir R Mehta
(Affiliation: Department of Medicine, McMaster University and Population Health Research Institute, Hamilton Health Sciences, Hamilton, Canada.)
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| Journal | European heart journal
(Eur Heart J)
Vol. 30
Issue 8
Pg. 900-7
(Apr 2009)
ISSN: 1522-9645 [Electronic] England |
| PMID | 18819961
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
|
| Chemical References |
- Platelet Aggregation Inhibitors
- Aspirin
- Ticlopidine
- clopidogrel
|
| Topics |
- Angioplasty, Transluminal, Percutaneous Coronary
(mortality)
- Aspirin
(administration & dosage, adverse effects)
- Death, Sudden, Cardiac
(etiology)
- Double-Blind Method
- Female
- Hemorrhage
(chemically induced, mortality)
- Humans
- Kaplan-Meiers Estimate
- Male
- Middle Aged
- Myocardial Infarction
(mortality, therapy)
- Myocardial Ischemia
(prevention & control)
- Platelet Aggregation Inhibitors
(administration & dosage, adverse effects)
- Stroke
(mortality, prevention & control)
- Ticlopidine
(administration & dosage, analogs & derivatives)
- Treatment Outcome
|
