Table 1. Details of randomised trials.
Source | Dose of aspirin and duration of follow-up (range, mean or median) | Number of subjects | Number of bleeds | Fatal bleeds | ||||
---|---|---|---|---|---|---|---|---|
Aspirin | No aspirin | Aspirin | No aspirin | Aspirin | No aspirin | |||
Peto et al (1988)[34] | 5,139 healthy male doctors | 500mg daily or 300 enteric coated for 5–6 years | 3,429 | 1,710 | 89 | 27 | 3 | 3 |
Physicians’ Health Study (1989)[35] | 22,071 healthy physicians (United States) | 325 mg alternate days for 60.2 months | 11,037 | 11,034 | 13 | 6 | 1 | 0 |
Swedish Angina Trial (1992)[36] | 1,360 patients with a transient ischaemic attack or myocardial infarction | 75 mg daily for 32 months | 676 | 684 | 9 | 4 | 1 | 1 |
Internat. Stroke Trial (1997)[37] | 19,435 Patients with ischaemic stroke | 300 mg daily for 6 months | 4,858 | 4,860 | 23 | 14 | 4 | 2 |
Thrombosis Prevention trial (1998)[38] | 5499 men at increased risk of vascular disease | 75 mg daily for 6.8 years | 1,268 | 1,272 | 7 | 4 | 1 | 2 |
Hansson et al (1998)[30] | Hypertensive patients on ‘optimal’ treatment | 75 mg daily for 3.8 years | 9,399 | 9,391 | 129 | 70 | 5 | 5 |
Primary Prev. Project (2001)[40] | 4,495 selected from general practitioner lists | 100 mg daily for 3–6 years | 2,226 | 2,269 | 17 | 5 | 1 | 3 |
Baron et al (2003)[41] | 1,121 patients selected at colo-rectal screening | 81 mg daily 325 mg daily each for 3 years | 377/372 | 372 | 2/4 | 3 | 0/1 | 0/0 |
Ridker (2005)[42] | 39,876 women | 100 mg alternate days for 10 years | 19,934 | 19,942 | 127 | 91 | 2 | 3 |
Belch et al (2008)[43] | 1,276 diabetic patients with arterial disease | 1900 mg daily for 6.7 years | 638 | 638 | 28 | 31 | 0 | 2 |
Brighton et al (2012)[44] | 822 patients with venous thrombosis | 100 mg daily for 37 months | 411 | 411 | 8 | 6 | 0 | 2 |
Risk of a GI bleed | ||||||||
On aspirin | 8/1000 | RR = 1.55 (1.32, 1.83) heterogeneity p = 0.401 | ||||||
On placebo | 5/1000 | |||||||
Risk of a bleed being fatal | ||||||||
On aspirin | 4% | RR = 0.45 (0.25, 0,80) heterogeneity p = 0.783 | ||||||
On placebo | 10% | |||||||
Risk of a fatal bleed if randomised to aspirin | ||||||||
On aspirin | 3.7/10,000 | RR = 0.77 (0.41, 1.43) heterogeneity p = 0.908 | ||||||
On placebo | 4.7/10,000 |
Abbreviations: CI: confidence interval; mg: milligrams; RCT: randomised controlled trial; RR: risk ratio.