"Aspirin in Unstable Angina Trial"
The New England Journal of Medicine. 1983. 309(7):396-403.
Contents
1 Clinical Question
2 Bottom Line
3 Major Points
4 Guidelines
5 Design
6 Population
6.1 Inclusion Criteria
6.2 Exclusion Criteria
6.3 Baseline Characteristics
7 Interventions
8 Outcomes
8.1 Primary Outcomes
8.2 Secondary Outcomes
9 Funding
10 Further Reading
Clinical Question
In men with unstable angina, does treatment with aspirin reduce the risk of death or acute myocardial infarction?
Bottom Line
In men with unstable angina, treatment with aspirin for 12 weeks led to a 51% reduction in the risk of death or acute myocardial infarction compared to placebo.
Major Points
Unstable angina is a condition with an increased risk of acute myocardial infarction and death. Prior to this study, the utility of aspirin in the management of unstable angina was not well defined.
Guidelines
Current guidelines were not influenced by this trial since it was conducted prior to the establishment of modern guideline processes.
Design
Multicenter, double-blind, placebo-controlled, randomized trial.
Population
Total number of participants: 1266 men
Inclusion Criteria
- Men with unstable angina
Exclusion Criteria
- Women were not included in this trial
Baseline Characteristics
- Men with unstable angina with various baseline characteristics.
Interventions
- Aspirin 324 mg in buffered solution daily for 12 weeks (n=625)
- Placebo (n=641)
Outcomes
Primary Outcomes
- Combined incidence of death or acute myocardial infarction after 12 weeks: 5.0% in the aspirin group vs. 10.1% in the placebo group (51% reduction; P = 0.0005).
Secondary Outcomes
- Incidence of nonfatal acute myocardial infarction: 3.4% in the aspirin group compared to 6.9% in the placebo group (51% reduction; P = 0.005).
- Reduction in mortality: 1.6% in the aspirin group compared to 3.3% in the placebo group (51% reduction; not statistically significant; P = 0.054).
- No significant difference in gastrointestinal symptoms or blood loss between groups.
Funding
Not specified.
Further Reading
Original publication in The New England Journal of Medicine (1983) 309:396–403.