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Title: Relation Between Aspirin Dose, All-Cause Mortality, and Bleeding in Patients With Recent Cerebrovascular or Coronary Ischemic Events (from the BRAVO Trial)
Authors: Aronow, Herbert D ×
Califf, Robert M
Harrington, Robert A
Vallee, Marc
Graffagnino, Carmelo
Shuaib, Ashfaq
Fitzgerald, Desmond J
Easton, J. Donald
Van de Werf, Frans
Diener, Hans-Christoph
Ferguson, James
Koudstaal, Peter J
Amarenco, Pierre
Theroux, Pierre
Davis, Stephen
Topol, Eric J #
Issue Date: Nov-2008
Publisher: Excerpta medica inc-elsevier science inc
Series Title: American journal of cardiology vol:102 issue:10 pages:1285-1290
Abstract: Despite aspirin's established role in the treatment of atherosclerotic vascular disease, considerable controversy exists regarding its most effective dosing strategy. In a retrospective observational study, we examined the relation between prescribed aspirin dose (< 162 mg vs >= 162 mg/day aspirin) and clinical outcome in 4,589 placebo-treated patients enrolled in the Blockage of the Glycoprotein IIb/IIIa Receptor to Avoid Vascular Occlusion (BRAVO) trial over a median follow-up of 366 days. Standard Cox regression analysis was employed because propensity analysis was not feasible. Compared with lower aspirin doses, higher doses were associated with lower unadjusted all-cause mortality (2.9 vs 1.6%, respectively; log rank chi-square 8.6, p = 0.0034). Higher aspirin dose remained independently predictive of lower all-cause mortality in a multivariable Cox proportional hazards model (hazard ratio 0.64, 95% confidence interval 0.42 to 0.97, p = 0.037). However, there was no significant difference in the incidence of the composite endpoint death, nonfatal myocardial infarction, cl nonfatal stroke (6.1% vs 6.2%, p = 0.74). Higher aspirin dose was a significant independent predictor of any (hazard ratio 1.32, 95% confidence interval 1.12 to 1.55, p = 0.001) but not serious bleeding. In conclusion, our findings suggest that aspirin doses of >= 162 mg/day may be more beneficial than those <162 mg/day at preventing death. (C) 2008 Elsevier Inc. All rights reserved. (Am J Cardiol 2008;102:1285-1290)
URI: 
ISSN: 0002-9149
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Cardiology
× corresponding author
# (joint) last author

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