Aspirin therapy (150-200 mg/day) did not show superiority over no treatment for preventing cardiovascular death, brain infarction, or TIA in NVAF patients (3.1% vs 2.4% per year).
RCT (n=871)
Yes
Does aspirin 150 to 200 mg per day reduce cardiovascular death, symptomatic brain infarction, or transient ischemic attack in Japanese patients with nonvalvular atrial fibrillation?
Aspirin at 150 to 200 mg per day is neither effective nor safe for the primary prevention of stroke in Japanese patients with nonvalvular atrial fibrillation.
Absolute Event Rate: 3.1% vs 2.4%
BACKGROUND AND PURPOSE: Although the efficacy of anticoagulant therapy for primary prevention of stroke in patients with nonvalvular atrial fibrillation (NVAF) has been established, efficacy of antiplatelet therapy for low-risk patients is disputable in Japanese patients because of the frequent hemorrhagic complications. We examined the efficacy and safety of aspirin therapy in Japanese patients with NVAF in a prospective randomized multicenter trial. METHODS: Patients with NVAF were randomized to an aspirin group (aspirin at 150 to 200 mg per day) or a control group without antiplatelet or anticoagulant therapy. Primary end points included cardiovascular death, symptomatic brain infarction, or transient ischemic attack. RESULTS: A total of 426 patients were randomized to aspirin group and 445 to no treatment. The trial was stopped earlier because there were 27 primary end point events (3.1% per year; 95% CI, 2.1% to 4.6% per year) in the aspirin group versus 23 (2.4% per year; 95% CI, 1.5% to 3.5% per year) in the control group, suggesting a low possibility of superiority of the aspirin treatment for prevention of the primary end point. In addition, treatment with aspirin caused a marginally increased risk of major bleeding (7 patients; 1.6%) compared with the control group (2 patients; 0.4%; Fisher exact test P=0.101). CONCLUSIONS: For prevention of stroke in patients with NVAF, aspirin at 150 to 200 mg per day does not seem to be either effective or safe. Further prospective studies are needed to determine the best preventive therapy for cerebrovascular events in Japanese patients with NVAF.
Sato et al. (Fri,) conducted a rct in Nonvalvular atrial fibrillation (NVAF) (n=871). Aspirin vs. No antiplatelet or anticoagulant therapy was evaluated on Cardiovascular death, symptomatic brain infarction, or transient ischemic attack. Aspirin therapy (150-200 mg/day) did not show superiority over no treatment for preventing cardiovascular death, brain infarction, or TIA in NVAF patients (3.1% vs 2.4% per year).
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