title: Low-dose versus high-dose aspirin after percutaneous coronary intervention: analysis from the guthrie health off-label StenT (GHOST) registry.
abstract: BACKGROUND
  The optimal dose of aspirin therapy after percutaneous coronary intervention (PCI) remains unclear. We sought to compare the effectiveness and safety of low and high doses of aspirin in preventing adverse outcomes after PCI.
  
  
  METHODS
  We studied 2,820 consecutive patients who underwent coronary stenting for stable or unstable coronary artery disease (excluding cardiogenic shock) discharged alive without any complications between 2001 and 2007. Patients were categorized based on the discharge aspirin dose into low-dose (81 mg/day, N = 313) or high-dose (162-325 mg/day, N = 2,507) groups. The primary end-points (adjusted using Cox Proportional Hazard and propensity scores) were major adverse cardiovascular events (MACE; a composite of death, myocardial infarction [MI], stent thrombosis [ST], or target vessel revascularization) and net adverse clinical events (NACE; a composite of MACE and thrombolysis in myocardial infarction [TIMI][major or minor] bleeding) at 1 year.
  
  
  RESULTS
  In the low-dose versus high-dose groups, MACE occurred in 8.6 versus 9.2% (log rank P = 0.71) and NACE in 11 versus 10% (log rank P = 0.58). In multivariable analysis, low-dose aspirin was not associated with worse outcomes (adjusted HR [95% CI] 0.74 [0.49-1.14] for MACE; 1.03 [0.71-1.50] for NACE).
  
  
  CONCLUSIONS
  Low-dose aspirin, as prescribed in this study of routine practice, was not associated with worse outcomes compared to high-dose aspirin. (J Interven Cardiol 2011;24:307-314).
authors.affiliation: Guthrie Clinic, Sayre, Pennsylvania William Beaumont Hospital, Royal Oak, Michigan. harjai_kishore@guthrie.org
authors.forename: Kishore J
authors.initials: KJ
authors.lastname: Harjai
authors.forename: Chetan
authors.initials: C
authors.lastname: Shenoy
authors.forename: Pam
authors.initials: P
authors.lastname: Orshaw
authors.forename: Samer
authors.initials: S
authors.lastname: Usmani
authors.forename: Maninder
authors.initials: M
authors.lastname: Singh
authors.forename: Judy
authors.initials: J
authors.lastname: Boura
authors.forename: Rajendra H
authors.initials: RH
authors.lastname: Mehta
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000628:therapy*; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin