Aspirin's Benefits Unclear in PAD Patients
Analysis Fails to Clarify Role of Aspirin Therapy in Patients With Peripheral Artery Disease
Aspirin for PAD: More Study Needed continued...
The study authors were careful to point out that the current evidence was insufficient to rule out small but important benefits of aspirin (as suggested by the point estimate of a 12% risk reduction).
Cardiologist and study co-author Mori J. Krantz, MD, of the Colorado Prevention Center, tells WebMD that a large, randomized study is needed to fully understand the risks versus benefits of aspirin therapy in patients with PAD.
“The benefits of aspirin therapy in coronary artery disease are unequivocal, but we can’t say the same for patients with peripheral artery disease,” he says. “In this era of evidence-based medicine, we owe it to ourselves to adequately study this drug regimen in this population.”
Internist and PAD researcher Mary McGrae McDermott, MD, of Northwestern University’s Feinberg School of Medicine, agrees.
“This analysis gives a more complete picture of the benefits of aspirin in patients with peripheral artery disease, but we need more data,” McDermott tells WebMD.
She points out that of the 18 studies included in the analysis, 15 were published more than a decade ago. In addition, some of the studies involved small numbers of patients and were of short duration, potentially skewing the results.
“To best inform evidence-based clinical practice guidelines, more high-quality clinical trials are needed,” she writes in an editorial published with the study. But McDermott concludes that “based on the limitations of data available, the findings [of the present study] should not alter recommendations for aspirin as an important therapeutic tool for secondary prevention in patients with PAD.”
Hiatt tells WebMD that a trial now under way in the United Kingdom could help clarify the role of aspirin in patients with peripheral artery disease.
Although the value of aspirin therapy in patients with PAD remains a subject of debate, Hiatt says there is no debate about the benefits of other preventive therapies like cholesterol -- and blood pressure-lowering drugs for lowering cardiovascular risk in this patient population.
“The real downside is that patients will ignore these other risk factors because they think aspirin alone will keep them from having a heart attack or stroke,” he says. “It is much more important that they stay on the drugs that have been proven to reduce their risk.”