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EDITOR
The worldwide meta-analysis of antiplatelet trials shows
that low dose aspirin (or some other effective antiplatelet regimen)
reduces non-fatal myocardial infarction, non-fatal stroke, and vascular
death in a wide range of patients who are at high risk of occlusive
vascular disease.1 A paper disputing this was published
concurrently in the For Debate section of the journal,2 but the arguments in it (some of which the author also published on
the same date in an editorial in the Lancet)3
depend strongly on quite simple mistakes about the randomised evidence
and could cause unnecessary deaths.
Consider, for example, the ISIS-2 trial of short term antiplatelet
therapy, in which 17 187 patients with suspected acute myocardial
infarction were randomised, half to active aspirin and half to
placebo.4 This trial showed a clear reduction in five week
all cause mortality (811/8587 (9.4%) aspirin v 1030/8600 (12.0%) placebo deaths, 2P<0.00001).5 Bizarrely, in a
if data are massaged sufficiently
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