Published 19 November 2008, doi:10.1136/bmj.a2581
Cite this as: BMJ 2008;337:a2581

Letters

POPADAD trial

Don’t stop taking aspirin

The first 150 words of the full text of this article appear below.

The POPADAD trial shows no benefit from daily prophylactic aspirin (hazard ratio 0.98; P=0.87) in people who have diabetes and early peripheral arterial disease. However, no firm conclusions should be drawn from a single trial, but the result be incorporated in a meta-analysis of all available evidence from relevant trials.¹

The absence of evidence of benefit is not surprising as the trial was seriously underpowered. The annual cardiovascular event rate observed was only 2.9%, while the event rate expected was 8%. The 95% confidence limits for the effect of aspirin (0.76 to 1.26) include a possible 24% reduction in vascular events. This is consistent with the effect of aspirin in other trials of primary prevention. It is also consistent with the CLIPS trial in people with peripheral arterial disease, 76% of whom also had diabetes, in which low dose aspirin prophylaxis was associated with a significant reduction in vascular events . . . [Full text of this article]

¹ School of Medicine, Cardiff University, Cardiff CF14 4XN

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

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

Jill Belch, Angus MacCuish, Iain Campbell, Stuart Cobbe, Roy Taylor, Robin Prescott, Robert Lee, Jean Bancroft, Shirley MacEwan, James Shepherd, Peter Macfarlane, Andrew Morris, Roland Jung, Christopher Kelly, Alan Connacher, Norman Peden, Andrew Jamieson, David Matthews, Graeme Leese, John McKnight, Iain O’Brien, Colin Semple, John Petrie, Derek Gordon, Stuart Pringle, Ron MacWalter, and Prevention of Progression of Arterial Disease and Diabetes Study Group, Diabetes Registry Group, and Royal College of Physicians Edinburgh
BMJ 2008 337: a1840. [Abstract] [Full Text] [PDF]

Joint British recommendations on prevention of coronary heart disease in clinical practice: summary

British Cardiac Society, British Hyperlipidaemia Association, British Hypertension Society, and British Diabetic Association
BMJ 2000 320: 705-708. [Extract] [Full Text] [PDF]

Online poll

Find out more >>