Clinical characteristics of nonfatal myocardial infarction among individuals on prophylactic low-dose aspirin therapy.
Key result
Alternate-day aspirin reduced the occurrence of first nonfatal myocardial infarction compared to placebo (129 vs 213 cases; p<0.00001), but did not affect the clinical characteristics of the events.
Why the study?
Does alternate-day aspirin 325 mg affect the clinical characteristics of subsequent nonfatal myocardial infarction in US male physicians?
Population
22,071 US male physicians
Comparison
Aspirin 325 mg alternate-day vs Placebo
Design
RCT, randomized, double-blind, placebo-controlled
Follow-up
60.2 months
Authors
Discussion
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Implication
Supports aspirin for primary MI prevention in male physicians; confirms benefit is incidence reduction alone, without milder events.
Study Design
Type
RCT (n=22,071)
Blinding
double-blind
Randomization
randomized
Structured PICO
Does alternate-day aspirin 325 mg affect the clinical characteristics of subsequent nonfatal myocardial infarction in US male physicians?
P
Population
22,071 US male physicians followed for 60.2 months to evaluate the effect of alternate-day aspirin on the incidence and clinical characteristics of nonfatal myocardial infarction.
I
Intervention
Aspirin 325 mg alternate-day
C
Comparator
Placebo
O
Outcome
Clinical characteristics of subsequent nonfatal myocardial infarction (size, location, electrocardiographic features, postinfarction left ventricular ejection fraction, and distribution or number of coronary vessels obstructed)
Main Result
Absolute Event Rate: 1.17% vs 1.93%
p-value: p=<0.00001
Prophylactic alternate-day aspirin reduces the risk of a first nonfatal myocardial infarction but does not alter the clinical characteristics or severity of the infarctions that do occur.
Cite This Study
Ridker et al. (1991) conducted an RCT in nonfatal myocardial infarction (n=22,071). Alternate-day aspirin vs. placebo was evaluated on incident cases of nonfatal myocardial infarction (p=<0.00001). Alternate-day aspirin reduced the occurrence of first nonfatal myocardial infarction compared to placebo (129 vs 213 cases; p<0.00001), but did not affect the clinical characteristics of the events.