Trial reportBMJ (Clinical research ed.)2008
The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease.
Trial report in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03869268 (The Impact of Aspirin Dose Modification on the Innate Immune Response - Will Lower Dose Aspirin Therapy Reduce the Response to Endotoxin), which is not on this map. Cited by 295 papers, 34 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Impact of Aspirin Dose Modification on the Innate Immune Response - Will Lower Dose Aspirin Therapy Reduce the Response to Endotoxin
Who cites it
295 citing papers in PubMed, 34 syntheses or guidelines pooled it, 969 citations in OpenAlex.
- 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2026.Diabetes care · 2026Guideline
- 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Guideline
- The Role of Cilostazol, a Phosphodiesterase-3 Inhibitor, in the Development of Atherosclerosis and Vascular Biology: A Review with Meta-Analysis.International journal of molecular sciences · 2024Pooled it
- Benefits and Risks Associated with Low-Dose Aspirin Use for the Primary Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Randomized Control Trials and Trial Sequential Analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2022Pooled it
- Pooled it
- Effects of vitamin E on stroke: a systematic review with meta-analysis and trial sequential analysis.Stroke and vascular neurology · 2021Pooled it
- Benefits and Risks Associated With Aspirin Use in Patients With Diabetes for the Primary Prevention of Cardiovascular Events and Mortality: A Meta-Analysis.Frontiers in endocrinology · 2021Pooled it
- Aspirin for primary prevention of cardiovascular outcomes in diabetes mellitus: An updated systematic review and meta-analysis.European journal of preventive cardiology · 2020Pooled it
- Canadian Stroke Best Practice Recommendations, seventh edition: acetylsalicylic acid for prevention of vascular events.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Guideline
- Aspirin for primary prevention of stroke in individuals without cardiovascular disease-A meta-analysis.International journal of stroke : official journal of the International Stroke Society · 2020Pooled it
- Aspirin for primary prevention of cardiovascular disease: a meta-analysis with a particular focus on subgroups.BMC medicine · 2019 · on this mapPooled it
- 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2019Guideline
- Aspirin Efficacy in Primary Prevention: A Meta-analysis of Randomized Controlled Trials.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2019Pooled it
- Safety and efficacy of aspirin for primary prevention of cancer: a meta-analysis of randomized controlled trials.Journal of cancer research and clinical oncology · 2019Pooled it
- Aspirin has potential benefits for primary prevention of cardiovascular outcomes in diabetes: updated literature-based and individual participant data meta-analyses of randomized controlled trials.Cardiovascular diabetology · 2019Pooled it
- Pooled it
- Critical appraisal of international guidelines for the screening and treatment of asymptomatic peripheral artery disease: a systematic review.BMC cardiovascular disorders · 2019Pooled it
- Pooled it
- Pooled it
235 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
29 authors at 14 institutions in 1 country.
Funding
Abstract
objectiveTo 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.
designMulticentre, randomised, double blind, 2x2 factorial, placebo controlled trial.
setting16 hospital centres in Scotland, supported by 188 primary care groups.
participants1276 adults aged 40 or more with type 1 or type 2 diabetes and an ankle brachial pressure index of 0.99 or less but no symptomatic cardiovascular disease.
interventionsDaily, 100 mg aspirin tablet plus antioxidant capsule (n=320), aspirin tablet plus placebo capsule (n=318), placebo tablet plus antioxidant capsule (n=320), or placebo tablet plus placebo capsule (n=318).
main outcome measuresTwo hierarchical composite primary end points of death from coronary heart disease or stroke, non-fatal myocardial infarction or stroke, or amputation above the ankle for critical limb ischaemia; and death from coronary heart disease or stroke.
resultsNo evidence was found of any interaction between aspirin and antioxidant. Overall, 116 of 638 primary events occurred in the aspirin groups compared with 117 of 638 in the no aspirin groups (18.2% v 18.3%): hazard ratio 0.98 (95% confidence interval 0.76 to 1.26). Forty three deaths from coronary heart disease or stroke occurred in the aspirin groups compared with 35 in the no aspirin groups (6.7% v 5.5%): 1.23 (0.79 to 1.93). Among the antioxidant groups 117 of 640 (18.3%) primary events occurred compared with 116 of 636 (18.2%) in the no antioxidant groups (1.03, 0.79 to 1.33). Forty two (6.6%) deaths from coronary heart disease or stroke occurred in the antioxidant groups compared with 36 (5.7%) in the no antioxidant groups (1.21, 0.78 to 1.89).
conclusionThis trial does not provide evidence to support the use of aspirin or antioxidants in primary prevention of cardiovascular events and mortality in the population with diabetes studied.
trial registrationCurrent Controlled Trials ISRCTN53295293.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.