ADAPTABLE Comparative Effectiveness of Aspirin Dosing in Cardiovascular Disease
In this pragmatic trial involving patients with established cardiovascular disease, there was substantial dose switching to 81 mg of daily aspirin and no significant differences in cardiovascular events or major bleeding between patients assigned to 81 mg and those assigned to 325 mg of aspirin daily.
A total of 15,076 patients were followed for a median of 26.2 months.
primary effectiveness outcome was a composite of death from any cause, hospitalization for myocardial infarction, or hospitalization for stroke.
Death, hospitalization for myocardial infarction, or hospitalization for stroke occurred in 590 patients (7.28%) in the 81-mg group and 569 patients ( 7.51%) in the 325-mg group (HR 1.02). Hospitalization for major bleeding occurred in 53 patients ( 0.63%) in the 81-mg group and 44 patients (, 0.60%) in the 325-mg group (HR 1.18). Patients assigned to 325 mg had a higher incidence of dose switching than those assigned to 81 mg (41.6% vs. 7.1%) and fewer median days of exposure to the assigned dose (434 days vs. 650 days.
Aspirin Primary Prevention