Evidence map›Paper›PMID 39117415›Full record

Trial reportBMJ open2024

Impact of aspirin dose according to race in secondary prevention of atherosclerotic cardiovascular disease: a secondary analysis of the ADAPTABLE randomised controlled trial.

Guillaume Marquis-Gravel, Hillary Mulder, Lisa M Wruck, Catherine P Benziger, Mark B Effron, Peter M Farrehi, Saket Girotra, Kamal Gupta, Sunil Kripalani, Daniel Muñoz and 6 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02697916 (Aspirin Dosing), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT02697916 nacompletednot on this map

Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-term Effectiveness

TypeinterventionalSponsorDuke UniversityRan2016 to 2020Enrolled15,076ConditionsAtherosclerotic Cardiovascular DiseaseArmsaspirin
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Guillaume Marquis-GravelDuke Clinical Research Institute, Durham, North Carolina, USA guillaume.marquis.gravel@umontreal.ca.ORCID 0000-0003-2965-1504
Hillary MulderDuke Clinical Research Institute, Durham, North Carolina, USA.
Lisa M WruckDuke Clinical Research Institute, Durham, North Carolina, USA.ORCID 0000-0003-1732-9067
Catherine P BenzigerHeart and Vascular Center, Essentia Health, Duluth, Minnesota, USA.
Mark B EffronJohn Ochsner Heart and Vascular Institute, New Orleans, Louisiana, USA.
Peter M FarrehiUniversity of Michigan, Ann Arbor, Michigan, USA.
Saket GirotraUniversity Texas Southwestern Medical Center, Dallas, Texas, USA.
Kamal GuptaUniversity of Kansas Medical Center, Kansas City, Kansas, USA.
Sunil KripalaniVanderbilt University Medical Center, Nashville, Tennessee, USA.
Daniel MuñozVanderbilt University Medical Center, Nashville, Tennessee, USA.
Tamar S PolonskyUniversity of Chicago Medicine, Chicago, Illinois, USA.
Jeff WhittleMedical College of Wisconsin, Milwaukee, Wisconsin, USA.ORCID 0000-0002-9544-838X
Robert HarringtonStanford University, Stanford, California, USA.
Russell RothmanVanderbilt University Medical Center, Nashville, Tennessee, USA.
Adrian F HernandezDuke University, Durham, North Carolina, USA.
W S JonesDuke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate whether the effectiveness and safety of low (81 mg daily) versus high-dose (325 mg daily) aspirin is consistent across races among patients with established atherosclerotic cardiovascular disease (ASCVD).

designA secondary analysis of the randomised controlled trial ADAPTABLE was performed.

settingThe study was conducted in 40 centres and one health plan participating in the National Patient-Centred Clinical Research Network (PCORnet) in the USA.

participantsAmong 15 076 participants with established ASCVD, 14 096 had self-reported race available and were included in the analysis. Participants were divided according to self-reported race as Black (n=1311, 9.3%), White (n=11 990, 85.1%) or other race (n=795, 5.6%).

interventionsParticipants were randomised to open-label daily aspirin doses of 81 mg versus 325 mg in a 1:1 ratio for a median of 26.2 months. PRIMARY AND SECONDARY OUTCOMES MEASURES: The primary effectiveness endpoint was a composite of death from any cause, hospitalisation for myocardial infarction or hospitalisation for stroke. The primary safety endpoint was hospitalisation for bleeding requiring blood product transfusion.

resultsEstimated cumulative incidence of the primary effectiveness endpoint at median follow-up with the 81 mg and the 325 mg daily doses were 6.70% and 7.12% in White participants (adjusted HR: 1.00 [95% CI: 0.88 to 1.15]); 12.27% and 10.69% in Black participants (adjusted HR: 1.40 [95% CI: 1.02 to 1.93]); and 6.88% and 7.69% in other participants (adjusted HR: 0.86 [95% CI: 0.54 to 1.39]) (p-interaction=0.12), respectively. There was no significant interaction between self-reported race and assigned aspirin dose regarding the secondary effectiveness and the primary safety endpoints.

conclusionRace is not an effect modifier on the impact of aspirin dosing on effectiveness and safety in patients with established ASCVD. In clinical practice, treatment decisions regarding aspirin dose in secondary prevention of ASCVD should not be influenced by race. TRIAL REGISTRATION NUMBER: NCT02697916.

Indexed as

AspirinAtherosclerosisPlatelet Aggregation InhibitorsSecondary PreventionAgedBlack or African AmericanCardiovascular DiseasesDose-Response Relationship, DrugFemaleHemorrhageHospitalizationHumansMaleMiddle AgedMyocardial InfarctionStrokeAspirinPlatelet Aggregation InhibitorsCARDIOLOGYCLINICAL PHARMACOLOGYMyocardial infarction

Identifiers

PMID39117415
PMCPMC11407226

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

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.