Aspirin Appears To Be Associated With Lower Risk Of Stroke For Patients With Peripheral Artery Disease
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An analysis of preceding studies indicates that among patients with peripheral artery disease, aspirin application is associated with a statistically nonsignificant cut in the risk of a group of combined cardiovascular events (nonfatal heart attack, nonfatal stroke, and cardiovascular death), but is associated with a meaning diminution in the risk of one of these events, nonfatal stroke, although the findings may be resident by the exigency of a large study population, according to an article in the May 13 problem of JAMA.
Although aspirin is effective in the prevention of cardiovascular events in patients with symptomatic coronary affection disease and cerebrovascular disease, its backlash in patients with peripheral artery disease (PAD) has been uncertain, according to background data in the article. Despite limited supporting data, some happening guidelines reccomend aspirin handle for patients with PAD (partial or complete blockage of an artery, normally one leading to a leg or arm, with symptoms including fatigue, cramping and pain from walking; and when the arm is in motion, discomfort, heaviness, tiredness and cramping).
To assess the end of aspirin on cardiovascular act rates in patients with PAD, Jeffrey S. Berger, M.D., M.S., of the University of Pennsylvania, Philadelphia, and colleagues conducted a meta-analysis to evaluate available evidence from randomized controlled trials of aspirin therapy, with or without dipyridamole (an antiplatelet agent), that reported cardiovascular circumstance rates (the primary events for this analysis were nonfatal myocardial infarction [MI; heart attack], nonfatal stroke, and cardiovascular death). The researchers identified 18 trials, which included 5,269 patients, of whom 2,823 were randomized to aspirin therapy (of these, 1,516 received aspirin monotherapy) and 2,446 were randomized to placebo or control.
The researchers found that a total of 251 (8.9 percent) cardiovascular events occurred among the patients receiving any aspirin therapy compared with 269 (11.0 percent) events among the governance patients, a 12 percent reduction in cardiovascular naked truth rates, which was not statistically significant. Results for associations of aspirin therapy with the individual components of the primary events indicated that the risk of nonfatal stroke was significantly lower (34 percent) in the aspirin batch than in the placebo (a ratio of events of 1.8 percent vs. 3.1 percent), on the other hand was not associated with expressive reductions in all-cause or cardiovascular death, heart attack, or major bleeding.
A total of 125 cardiovascular events occurred among 1,516 patients (8.2 percent) receiving aspirin monotherapy compared with 144 events among 1,503 patients (9.6 percent) in the placebo or control groups. Aspirin monotherapy was associated with a 36 percent lessening in the risk of nonfatal stroke (2.1 percent vs. 3.4 percent), however no statistically significant reductions in all-cause or cardiovascular death, emotions attack, or better bleeding.
"Results of this meta-analysis demonstrated that for patients with PAD, aspirin therapy alone or in combination with dipyridamole did not significantly decrease the substantial bound point of cardiovascular events, results that may reflect limited statistical power," the authors write. "The major limitations of this meta-analysis flash the limitations of published literature on aspirin for treating PAD. Multiplied of these trials were small and of short duration, resulting in few major cardiovascular events."
"However the current evidence was inadequate to law gone small yet important benefits of aspirin (as suggested by the aim estimate of a 12 percent risk reduction)," they add. "Larger prospective studies of aspirin and other antiplatelet agents are warranted among patients with PAD in plan to draw firm conclusions about clinical betterment and risks."
Journal of the American Medical Corporation
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