'So I think that made it more challenging.' Primary prevention guidelines that downgraded aspirin and dual antiplatelet therapy guidelines that recommended a 81-mg dose both came out during the course of the trial, he noted. Nearly 42% of the group randomized to 325 mg switched to the lower dose, often on the recommendation of their physician, whereas 7.1% moved to the higher dose from 81 mg under the open-label design.Ĭlinicians' prevailing beliefs and perspectives on the best dose were likely at play, Jones suggested. The data were simultaneously published in the New England Journal of Medicine.īut for patients starting or restarting aspirin, the 81-mg dose 'is probably right, due to better tolerability,' Jones said, since there was no conclusive evidence that the higher dose is better.
Patients doing well on their current dose should be fine to stay there, with no mandate to switch, Jones concluded at the American College of Cardiology (ACC) virtual meeting. Hospitalization for major bleeding with transfusion of a blood product, the primary safety endpoint, occurred in 0.63% and 0.60% of patients, respectively (53 vs 44 patients, HR 1.18, 95% CI 0.79-1.77).
