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March 1, 1986Diabetes Care

Veterans Administration Cooperative Study on Antiplatelet Agents in Diabetic Patients After Amputation for Gangrene: II. Effects of Aspirin and Dipyridamole on Atherosclerotic Vascular Disease Rates

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Why the study?

Does aspirin plus dipyridamole reduce death from atherosclerotic vascular disease and amputation of the opposite extremity in non-insulin-dependent diabetic men with recent amputation or active gangrene?

Population

231 non-insulin-dependent diabetic men with either a recent amputation for gangrene or active gangrene

Comparison

Aspirin plus dipyridamole vs Placebo

Design

RCT, randomized

Authors

JCJohn A. ColwellThe University of QueenslandSBStephen F. BinghamNottingham Trent UniversityCACarlos AbrairaWest Los Angeles College

Discussion

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Implication

No benefit over placebo for death or amputation in this population; extends evidence against routine combination antiplatelet use in diabetic men post-amputation.

Structured PICO

Does aspirin plus dipyridamole reduce death from atherosclerotic vascular disease and amputation of the opposite extremity in non-insulin-dependent diabetic men with recent amputation or active gangrene?

P
Population
231 non-insulin-dependent diabetic men with either a recent amputation for gangrene or active gangrene
I
Intervention
Aspirin plus dipyridamole
C
Comparator
Placebo
O
Outcome
Death from atherosclerotic vascular disease plus amputation of the opposite extremity for gangrenecomposite

Aspirin plus dipyridamole does not significantly reduce the risk of atherosclerotic death or opposite-extremity amputation in diabetic men with gangrene compared to placebo.

Limitations

  • Secondary endpoint findings (strokes and transient ischemic attacks) were found only after multiple analyses of the data and must be interpreted with caution

Cite This Study

Colwell et al. (1986) studied this question.

synapsesocial.com/papers/6a82c47388f77a62c2a0cd83https://doi.org/10.2337/diacare.9.2.140
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Also Consider

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

  1. 1VA Cooperative Study on Antiplatelet Agents in Diabetic Patients after Amputation for Gangrene2009 · 14 citations
  2. 2Random control trial of a short course of aspirin and dipyridamole (Persantin) for femorodistal grafts1987 · 89 citations
  3. 3Systematic review of antiplatelet therapy for the prevention of myocardial infarction, stroke or vascular death in patients with peripheral vascular disease2001 · 176 citations
  4. 4Aspirin, Dipyridamole and Platelet Survival in Patients with Diabetes Mellitus1982 · 7 citations
  5. 5Randomised placebo controlled trial of aspirin and dipyridamole in the prevention of coronary vein graft occlusion.1985 · 63 citations