Aspirin for Prevention of Cardiovascular Events in a General Population Screened for a Low Ankle Brachial Index

Published on Jan 1, 2015
F. Gerald2
Estimated H-index: 2
R. Fowkes2
Estimated H-index: 2
+ 7 AuthorsGordon D. Murray112
Estimated H-index: 112
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#2Colin BaigentH-Index: 81
#3Lisa BlackwellH-Index: 15
Last. Alberto ZanchettiH-Index: 129
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BACKGROUND: Low-dose aspirin is of definite and substantial net benefit for many people who already have occlusive vascular disease. We have assessed the benefits and risks in primary prevention. METHODS: We undertook meta-analyses of serious vascular events (myocardial infarction, stroke, or vascular death) and major bleeds in six primary prevention trials (95,000 individuals at low average risk, 660,000 person-years, 3554 serious vascular events) and 16 secondary prevention trials (17,000 indi...
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#1Jill J. F. Belch (Dund.: University of Dundee)H-Index: 78
#2Angus MacCuishH-Index: 2
Last. Ron MacWalter (Dund.: University of Dundee)H-Index: 8
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Objective To determine whether aspirin and antioxidant therapy, combined or alone, are more effective than placebo in reducing the development of cardiovascular events in patients with diabetes mellitus and asymptomatic peripheral arterial disease. Design Multicentre, randomised, double blind, 2×2 factorial, placebo controlled trial. Setting 16 hospital centres in Scotland, supported by 188 primary care groups. Participants 1276 adults aged 40 or more with type 1 or type 2 diabetes and an ankle ...
740 CitationsSource
#1Susan S. Ellenberg (UPenn: University of Pennsylvania)H-Index: 60
Data Monitoring Committees, also known as Data and Safety Monitoring Boards, are often established as a component of clinical trial oversight to review interim data of the ongoing trial so that safety concerns or problematic operational issues can be identified rapidly and corrective measures can be undertaken. Such committees may be independent of the trial sponsor and investigator to ensure recommendations are as objective as possible and unaffected by conflicts of interest. Federal funding an...
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#2F. Gerry R. Fowkes (Edin.: University of Edinburgh)H-Index: 31
#2F. G. R. Fowkes (Edin.: University of Edinburgh)H-Index: 59
Last. J. M. GuralnikH-Index: 23
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Prediction models to identify healthy individuals at high risk of cardiovascular disease have limited accuracy. A low ankle brachial index (ABI) is an indicator of atherosclerosis and has the potential to improve prediction.To determine if the ABI provides information on the risk of cardiovascular events and mortality independently of the Framingham risk score (FRS) and can improve risk prediction.Relevant studies were identified. A search of MEDLINE (1950 to February 2008) and EMBASE (1980 to F...
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#1Jackie F. Price (Edin.: University of Edinburgh)H-Index: 62
#2Marlene C. W. Stewart (Edin.: University of Edinburgh)H-Index: 20
Last. Gerald F. Fowkes (Edin.: University of Edinburgh)H-Index: 1
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ObjectivesAn increasing interest is observed in the use of the ankle brachial index (ABI, ratio of systolic blood pressure at the ankle to that in the arm) to assess cardiovascular risk. The aim of this study was to provide information on the distribution of ABI in a large healthy population, essential for planning implementation of ABI measurement in preventive strategies in the general population.Study design and settingCross-sectional survey of the ABI was conducted in 28980 men and women age...
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#1Ramzi Ajjan (University of Leeds)H-Index: 34
#2Robert F. Storey (University of Sheffield)H-Index: 90
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Despite multiple interventions to reduce the risk of cardiovascular disease, the majority of people with diabetes develop macrovascular complications, and mortality following myocardial infarction remains unacceptably high [1]. Antiplatelet agents are used for both the primary and secondary prevention of cardiovascular disease, although current guidelines are not consistent in their recommendation for the use of aspirin in diabetes [2]. In fact, there is little direct evidence supporting its eff...
66 CitationsSource
#1Lars NorgrenH-Index: 61
#2William R. Hiatt (University of Colorado Denver)H-Index: 96
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The Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease (TASC) was published in January 2000 as a result of cooperation between fourteen medical and surgical vascular, cardiovascular, vascular radiology and cardiology societies in Europe and North America. This comprehensive document had a major impact on vascular care amongst specialists. In subsequent years, the field has progressed with the publication of the CoCaLis document and the American College o...
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#1Paul M. Ridker (Brigham and Women's Hospital)H-Index: 252
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results During follow-up, 477 major cardiovascular events were confirmed in the aspirin group, as compared with 522 in the placebo group, for a nonsignificant reduction in risk with aspirin of 9 percent (relative risk, 0.91; 95 percent confidence interval, 0.80 to 1.03; P=0.13). With regard to individual end points, there was a 17 percent reduction in the risk of stroke in the aspirin group, as compared with the placebo group (relative risk, 0.83; 95 percent confidence interval, 0.69 to 0.99; P=...
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Diabetics are at high risk for atherosclerotic cardiovascular disease (ASCVD) and are considered a coronary heart disease risk equivalent. The utility of aspirin in primary prevention of ASCVD in diabetic patients has been widely studied and is still debated. Overall, the current evidence suggests a modest benefit for reduction in ASCVD events with the greatest benefit among those with higher baseline risk, but at the cost of increased risk of gastrointestinal bleeding. Diabetic patients at high...
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