Aspirin prevents vascular events in patients with PAD
Is low-dose aspirin effective in preventing serious vascular events in patients with peripheral arterial disease?
Low-dose aspirin prevents major vascular events in patients with peripheral arterial disease with a number needed to treat (NNT) of 14 for 2 years. The study was too small to assess whether there is a risk reduction in critical leg ischemia events. Many of these patients have an indication for aspirin based on the presence of established coronary artery disease or diabetes. (LOE = 1b)
Critical Leg Ischaemia Prevention Study (CLIPS) Group; Catalano M, Born G, Peto R. Prevention of serious vascular events by aspirin amongst patient with peripheral arterial disease: randomized, double-blind trial. Journal of Internal Medicine 2007;261:276-284. [PMID:17305650]
Randomized controlled trial (double-blinded)
Industry + foundation
The original plan for this study was to recruit a sample of 2000 patients with peripheral arterial disease. However, this became difficult because of widespread aspirin use for other indications, and recruitment was therefore stopped at 366 patients. A serious vascular event was defined as a fatal or nonfatal myocardial infarction or stroke, or death that could not be ascribed to a nonvascular cause such as cancer. Critical leg ischemia was defined as ischemic pain at rest for more than 2 weeks, with or without ulcers or gangrene, plus ankle and toe blood pressure criteria. Patients were randomized to 4 groups: aspirin 100 mg daily; antioxidant vitamins (vitamin E 600 mg, vitamin C 250 mg, and beta-carotene 20 mg); both; or neither. Diabetic patients were included. Patients were followed up every 3 months for 2 years. There was a significant reduction in major vascular events in the aspirin-treated groups: 7 of 185 versus 20 of 181 (4% vs 11%; P = .02; NNT = 14; 95% CI, 8-53). Critical leg ischemia occurred in 2.7% of aspirin-treated patients versus 4.4% of placebo patients (NS). As in other studies there was no benefit with antioxidant vitamins. Neither treatment was associated with an increase in adverse events in this small study.
Barry, Henry, et al., editors. "Aspirin Prevents Vascular Events in Patients With PAD." EE+ POEM Archive, John Wiley & Sons, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426055/all/Aspirin_prevents_vascular_events_in_patients_with_PAD.
Aspirin prevents vascular events in patients with PAD. In: Barry HH, Ebell MHM, Shaughnessy AFA, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2019. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426055/all/Aspirin_prevents_vascular_events_in_patients_with_PAD. Accessed December 5, 2023.
Aspirin prevents vascular events in patients with PAD. (2019). In Barry, H., Ebell, M. H., Shaughnessy, A. F., & Slawson, D. C. (Eds.), EE+ POEM Archive. John Wiley & Sons. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426055/all/Aspirin_prevents_vascular_events_in_patients_with_PAD
Aspirin Prevents Vascular Events in Patients With PAD [Internet]. In: Barry HH, Ebell MHM, Shaughnessy AFA, Slawson DCD, editors. EE+ POEM Archive. John Wiley & Sons; 2019. [cited 2023 December 05]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426055/all/Aspirin_prevents_vascular_events_in_patients_with_PAD.
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TY - ELEC T1 - Aspirin prevents vascular events in patients with PAD ID - 426055 ED - Barry,Henry, ED - Ebell,Mark H, ED - Shaughnessy,Allen F, ED - Slawson,David C, BT - EE+ POEM Archive UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426055/all/Aspirin_prevents_vascular_events_in_patients_with_PAD PB - John Wiley & Sons DB - Evidence Central DP - Unbound Medicine ER -