|
ACE
ASA and Carotid Endarterectomy
 |
Author(s) |
Taylor DW, Barnett HJM, Haynes RB, Ferguson GG, Sackett DL, Thorpe KE, Simard D, Silver FL, Hachinski V, Clagett GP, Barnes R, Spence JD
|
 |
Title(s) |
Low-dose and high-dose acetylsalicylic acid for patients undergoing carotid endarterectomy: a randomised controlled trial
|
|
Reference(s) |
Lancet 1999;353:2179-84
|
|
Disease |
Carotid artery stenosis
|
|
Purpose |
To compare the efficacy of high-dose and low-dose aspirin in reducing the risk of stroke in patients undergoing carotid endarterectomy
|
|
Study design |
Randomised, double-blind, parallel-group
|
|
Follow-up |
3 months
|
|
Patients |
2849 patients
|
|
Treatment regimen |
Aspirin, 81, 325, 650, or 1300 mg/day, starting before surgery
|
|
Concomitant therapy |
Heparin during surgery in 97% of patients, reversed at the end of the procedure in 44% of patients
|
|
Results |
The combined incidence of stroke, MI and death was lower in the low-dose (81 mg and 325 mg) groups than in the high-dose (650 mg and 1300 mg) groups at 30 days (5.4% vs 7.0%; p = 0.07) and at 3 months (6.2% vs 8.4%; p = 0.03). In an efficacy analysis, which excluded patients taking 650 mg or more of aspirin before randomisation and patients randomised within 1 day of surgery, the combined incidences in the low-dose and high-dose groups were 3.7% and 8.2%, respectively, at 30 days (p = 0.002) and 4.2% and 10.0% at 3 months (p = 0.0002)
|
|
|
|
