HIGH-DOSE ASPIRIN MAY SLOW CAROTID ATHEROSCLEROSIS

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HIGH-DOSE ASPIRIN MAY SLOW CAROTID ATHEROSCLEROSIS.

Some data suggest that long-term aspirin therapy can slow the progression of occlusive peripheral arterial disease, but it is unclear what dosage is required to achieve this benefit. These investigators studied 27 patients from a larger trial that compared low-dose with high-dose aspirin given after coronary angioplasty. These 27 patients had a total of 104 carotid atheromas and were followed with serial ultrasound studies.

After 1 year, the average plaque size had not changed in the 14 patients taking 900 mg of aspirin daily, but had increased by about one-third in the 13 patients taking the 50-mg dose. Ultrasonography documented the disappearance of 9 lesions in the high-dose group, but none in the low-dose group.

Comment: Although these data come from a small number of patients, they suggest that 50 mg of aspirin daily is not sufficient to slow progression of carotid atherosclerosis and that 900 mg may have beneficial effects. Because of the gastrointestinal side effects of high-dose aspirin, future studies should determine whether doses less than 900 mg would be equally effective.

— THL

Published in Journal Watch General Medicine June 29, 1993