title: Effects of aspirin dose on ischaemic events and bleeding after percutaneous coronary intervention: insights from the PCI-CURE study.
abstract: OBJECTIVE
  In the setting of percutaneous coronary intervention (PCI), due to a paucity of data, the optimal dose of aspirin is uncertain. We evaluated the safety of different doses of aspirin after PCI.
  
  
  RESULTS
  In the PCI-CURE study, 2658 patients with acute coronary syndromes undergoing PCI were stratified into three aspirin dose groups >/=200 mg (high, n = 1064), 101-199 mg (moderate, n = 538), and </=100 mg (low, n = 1056). For efficacy, the moderate- (7.4%) and high-dose groups (8.6%) had similar rates of cardiovascular death, myocardial infarction, or stroke compared with the low-dose group (7.1%). For safety, major bleeding was increased with high-dose aspirin [3.9, 1.5, and 1.9% in the high-, moderate-, and low-dose groups; hazard ratio (HR) of high vs. low dose 2.05 (95% CI 1.20-3.50, P = 0.009]. The net adverse clinical events (death, MI, stroke, major bleeding) favoured low-over high-dose aspirin (8.4 vs. 11.0%, HR 1.31, 95% CI 1.00-1.73 P = 0.056).
  
  
  CONCLUSIONS
  In this large observational analysis of patients undergoing PCI, low-dose aspirin appeared to be as effective as higher doses in preventing ischaemic events but was also associated with a lower rate of major bleeding and an improved net efficacy to safety balance.
authors.affiliation: Department of Medicine, McMaster University and Population Health Research Institute, Hamilton Health Sciences, Hamilton, Canada.
authors.forename: Sanjit S
authors.initials: SS
authors.lastname: Jolly
authors.forename: Janice
authors.initials: J
authors.lastname: Pogue
authors.forename: Kimberly
authors.initials: K
authors.lastname: Haladyn
authors.forename: Ron J G
authors.initials: RJ
authors.lastname: Peters
authors.forename: Keith A A
authors.initials: KA
authors.lastname: Fox
authors.forename: Alvaro
authors.initials: A
authors.lastname: Avezum
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Gersh
authors.forename: Hans Jurgen
authors.initials: HJ
authors.lastname: Rupprecht
authors.forename: Salim
authors.initials: S
authors.lastname: Yusuf
authors.forename: Shamir R
authors.initials: SR
authors.lastname: Mehta
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D000077144:Clopidogrel; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D017202:Myocardial Ischemia / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D020521:Stroke / Q000401:mortality / Q000517:prevention & control; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin