Elsevier

The Lancet

Volume 340, Issue 8833, 12 December 1992, Pages 1421-1425
The Lancet

ORIGINAL ARTICLES
Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with stable chronic angina pectoris

https://doi.org/10.1016/0140-6736(92)92619-QGet rights and content

Abstract

Clinical trials have demonstrated a prophylactic role for aspirin in myocardial infarction and in unstable angina pectoris. The Swedish Angina Pectoris Aspirin Trial (SAPAT) is the first prospective study of aspirin in stable angina.

2035 patients were randomised double-blind to treatment with aspirin 75 mg daily or placebo. All patients were treated with sotalol for control of symptoms. The median duration of follow-up was 50 months. Compared with the placebo + sotalol group, the aspirin + sotalol group had a 34% (81 vs 124 patients) reduction in primary outcome events (myocardial infarction and sudden death; 95% confidence interval 24-49%; p=0·003) and the reduction observed in secondary outcome events (vascular events, vascular death, all cause mortality, stroke) ranged from 22% to 32%. Treatment withdrawal caused by adverse events occurred in 109 patients in the aspirin + sotalol group and 100 in patients in the placebo + sotalol group; major bleeds, including haemorrhagic stroke, occurred in 20 and 13 patients, respectively (not significant).

The addition of a low dose of aspirin to sotalol treatment showed significant benefit in terms of cardiovascular events, including a significant reduction in the incidence of first myocardial infarction in patients with symptoms of stable angina pectoris.

References (19)

  • The RISC Group

    Risk of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease

    Lancet

    (1990)
  • Wb Kannel et al.

    Natural history of angina pectoris in the Framingham Study: prognosis and survival

    Am J Cardiol

    (1972)
  • Ga FitzGerald et al.

    Endogenous biosynthesis of prostacyclin and thromboxane and platelet function during chronic administration of aspirin in man

    J Clin Invest

    (1983)

  • Randomized trial of intravenous streptokinase, oral aspirin, both, or neither among 17 187 cases of suspected acute myocardial infarction: ISIS-2

    Lancet

    (1988)

  • Swedish aspirin low-dose trial (SALT) of 75 mg aspirin as secondary prophylaxis after cerebrovascular ischemic events

    Lancet

    (1991)
  • Steering Committee of the Physicians Health Study Research Group

    Final Report on the aspirin component of the ongoing Physicians Health Study

    N Engl J Med

    (1989)
  • C. Wilhelmsson et al.

    Comparison of once and twice daily sotalol in exercise-induced angina pectoris

    Eur J Clin Pharmacol

    (1982)
  • World Health Organisation

    Ischaemic heart disease registers; report of the Fifth Working Group, including a second revision of the operating protocol (Copenhagen, April 26-29, 1971)

    (1971)
  • La Cobb et al.

    Resuscitation from out-of-hospital ventricular fibrillation: 4-years follow-up

    Circulation

    (1975)
There are more references available in the full text version of this article.

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