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Aspirin Benefit Not Seen With Low Ankle Brachial Index

Aspirin not associated with reduction in vascular events in subjects with ABI of 0.95 or less

TUESDAY, March 2 (HealthDay News) -- The use of aspirin may not lead to fewer vascular events in middle-aged and older individuals with a low ankle brachial index (ABI), according to research published in the March 3 issue of the Journal of the American Medical Association.

F. Gerald R. Fowkes, Ph.D., of the University of Edinburgh in Scotland, U.K., and colleagues analyzed data from 3,350 individuals with an ABI of 0.95 or lower. Subjects had no history of cardiovascular disease. They were randomized to receive 100 mg of aspirin daily or placebo, and were followed for a mean 8.2 years for a composite of initial coronary event, stroke or revascularization.

The researchers found that event rates were not significantly different between the aspirin and placebo groups (13.7 and 13.3 per 1,000 person-years, respectively). The groups were also not significantly different for all-cause mortality (176 versus 186 deaths). The findings suggested a higher incidence of major hemorrhage in the aspirin group.

"Although this trial was not of screening per se, the results indicate that using the ABI in the community to screen individuals free of cardiovascular disease for an ABI of 0.95 or less is unlikely to be beneficial if aspirin is the intervention of choice. However, given the increased level of risk among those with a low ABI, the use of alternative therapies, such as statins or more potent antiplatelet agents without attendant hemorrhagic risks may usefully be considered," the authors write.

Several co-authors reported financial relationships with pharmaceutical companies, including Bayer HealthCare, which provided aspirin, placebo, and some funding for the study

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