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August 18, 1983New England Journal of Medicine

Protective Effects of Aspirin against Acute Myocardial Infarction and Death in Men with Unstable Angina

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Why the study?

Does aspirin reduce death and acute myocardial infarction in men with unstable angina?

Population

1266 men with unstable angina

Comparison

Aspirin 324 mg in buffered solution daily for 12… vs Placebo

Design

RCT, randomized, double-blind

Follow-up

12 weeks

Authors

HLH. Daniel Lewis21c Consultancy (United Kingdom)JDJames W. DavisUniversity of Hawaiʻi at MānoaDADonald ArchibaldKnopp Biosciences (United States)

Discussion

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Implication

Supports routine aspirin use in men with unstable angina; confirms benefit and informs future antiplatelet trials in ACS.

Key Points

  • To evaluate the protective effects of aspirin against acute myocardial infarction and death in men with unstable angina.
  • Conducted as a multicenter, double-blind, placebo-controlled randomized trial
  • Involved 1266 men with unstable angina, with 625 receiving aspirin and 641 receiving placebo
  • Treated participants with 324 mg of aspirin daily for 12 weeks
  • Incidence of death or acute myocardial infarction was 51% lower in the aspirin group (5.0% vs 10.1%, P=0.0005)
  • Nonfatal acute myocardial infarction was also 51% lower in the aspirin group (3.4% vs 6.9%, P=0.005)
  • Mortality reduction in the aspirin group was 51% (1.6% vs 3.3%), but not statistically significant (P=0.054)

Structured PICO

Does aspirin reduce death and acute myocardial infarction in men with unstable angina?

P
Population
1266 men with unstable angina
I
Intervention
Aspirin 324 mg in buffered solution daily for 12 weeks
C
Comparator
Placebo
O
Outcome
Composite of death and acute myocardial infarction (diagnosed by the presence of creatine kinase MB or pathologic Q-wave changes on electrocardiograms)composite

Aspirin 324 mg daily significantly reduces the risk of death or acute myocardial infarction in men presenting with unstable angina.

Cite This Study

Lewis et al. (1983) studied this question.

synapsesocial.com/papers/69f53ea9e0fbb6efbd203767https://doi.org/10.1056/nejm198308183090703
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A randomized, controlled trial of aspirin in persons recovered from myocardial infarction1980 · 89 citations
  2. 2Reduction or prevention of aspirin‐induced occult gastrointestinal blood loss in man1969 · 81 citations
  3. 3Evidence for transient limitations in coronary blood flow during unstable angina pectoris: hemodynamic changes with spontaneous pain at rest versus exercise‐induced ischemia following stabilization of angina1980 · 16 citations
  4. 4Persantine and aspirin in coronary heart disease. The Persantine-Aspirin Reinfarction Study Research Group.1980 · 468 citations
  5. 5A Randomized Controlled Trial of Acetyl Salicyclic Acid in the Secondary Prevention of Mortality from Myocardial Infarction1974 · 519 citations