Aims: In the setting of percutaneous coronary intervention (PCI), due to a paucity of data, the optimal dose of aspirin is uncertain. We evaluated the safety of different doses of aspirin after PCI.
Methods And Results: In the PCI-CURE study, 2658 patients with acute coronary syndromes undergoing PCI were stratified into three aspirin dose groups >/=200 mg (high, n = 1064), 101-199 mg (moderate, n = 538), and =100 mg (low, n = 1056). For efficacy, the moderate- (7.4%) and high-dose groups (8.6%) had similar rates of cardiovascular death, myocardial infarction, or stroke compared with the low-dose group (7.1%). For safety, major bleeding was increased with high-dose aspirin [3.9, 1.5, and 1.9% in the high-, moderate-, and low-dose groups; hazard ratio (HR) of high vs. low dose 2.05 (95% CI 1.20-3.50, P = 0.009]. The net adverse clinical events (death, MI, stroke, major bleeding) favoured low-over high-dose aspirin (8.4 vs. 11.0%, HR 1.31, 95% CI 1.00-1.73 P = 0.056).
Conclusion: In this large observational analysis of patients undergoing PCI, low-dose aspirin appeared to be as effective as higher doses in preventing ischaemic events but was also associated with a lower rate of major bleeding and an improved net efficacy to safety balance.
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http://dx.doi.org/10.1093/eurheartj/ehn417 | DOI Listing |
J Bone Joint Surg Am
January 2025
Department of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated with Wenzhou Medical University, Taizhou, Zhejiang, People's Republic of China.
Background: Joint arthroplasty effectively treats osteoarthritis, providing pain relief and improving function, but postoperative venous thromboembolism (VTE) remains a common complication. This study therefore assessed the effectiveness and safety of aspirin compared with oral anticoagulants (OACs) for VTE prophylaxis after joint arthroplasty.
Methods: A systematic review and meta-analysis was performed by searching PubMed, Embase, the Web of Science, and the Cochrane Library for randomized controlled trials (RCTs) up to May 14, 2024, that compared the effect of aspirin versus OACs on VTE prophylaxis in adults undergoing joint arthroplasty.
Front Pharmacol
January 2025
Department of Pharmacy, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
Background: Stroke is the leading cause of disability globally, with antiplatelet therapy being crucial for secondary prevention but also increasing bleeding risks. This requires careful dosage adjustments to balance thrombosis and bleeding risks.
Objective: This study compared the efficacy and safety of low-dose versus standard-dose antiplatelet therapy in stroke patients.
J Cardiothorac Surg
January 2025
Division of Clinical Medicine, University of Sheffield, Sheffield, UK.
Objective: Patients on direct-acting oral anticoagulants (DOACs) are at high risk of perioperative bleeding complications. Intraoperative hemoadsorption is a novel strategy to reduce perioperative bleeding in patients on DOACs undergoing non-deferable cardiac surgery. The international STAR-registry reports real-world clinical outcomes associated with this application.
View Article and Find Full Text PDFJ Hum Reprod Sci
December 2024
Department of Obstetrics and Gynecology, Faculty of Medicine Airlangga University, Airlangga University Hospital, Surabaya, Indonesia.
Background: Recurrent pregnancy loss (RPL) often stems from a hypercoagulable state that exacerbates conditions such as antiphospholipid syndrome (APS) and thrombophilia, leading to early placental issues. Although treatments such as low-molecular-weight heparin (LMWH) and low-dose aspirin (LDA) are used, outcomes vary. This study proposes using first-trimester Doppler ultrasound - specifically, uterine radial artery resistance index (URa-RI) at 8 weeks and uterine artery pulsatility index (Ut-PI) with pre-diastolic notching (Ut-notch) at 11-13 weeks - to better predict successful pregnancies and reduce risks of adverse outcomes.
View Article and Find Full Text PDFLancet Haematol
January 2025
Department of Medicine, McGill University, Montreal, QC, Canada.
Background: Despite the morbidity and mortality of venous thromboembolism, there is little evidence to guide postpartum thromboprophylaxis in patients at moderate risk. We aimed to assess the feasibility of conducting a double-blind, randomised trial of aspirin versus placebo in postpartum individuals with two or more venous thromboembolism risk factors, mild-to-moderate thrombophilia, or both.
Methods: The pilot PARTUM trial, a multi-national, randomised, double-blind, placebo-controlled trial, was conducted in seven centres across Canada, France, Ireland, and the Netherlands.
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