Elsevier

The Lancet

Volume 314, Issues 8156–8157, 29 December 1979, Pages 1313-1315
The Lancet

ASPIRIN AND SECONDARY MORTALITY AFTER MYOCARDIAL INFARCTION

https://doi.org/10.1016/S0140-6736(79)92808-3Get rights and content

Abstract

A randomised controlled double-blind trial of aspirin in the prevention of death was conducted in 1682 patients (including 248 women) who had had a confirmed myocardial infarct (MI). 25% of the patients were admitted to the trial within 3 days of the infarction and 50% within 7 days. Aspirin, 300 mg three times daily, was given for 1 yr. Total mortality was 12·3% in patients given aspirin and 14·8% in those given placebo, a reduction by aspirin of 17%, which was not statistically significant at p<0·05. The reduction in specific ischæmic-heart-disease (IHD) mortality was 22% and in total mortality plus IHD morbidity (readmission to hospital for MI in survivors) was 28%.

References (6)

  • Pc Elwood et al.

    A randomized controlled trial of acetyl salicylic acid in the secondary prevention of mortality from myocardial infarction

    Br Med J

    (1974)
  • The Coronary Drug Project Research Group

    Aspirin in coronary heart disease

    J Chron Dis

    (1976)
There are more references available in the full text version of this article.

Cited by (243)

  • Clinical decision-making: Challenging traditional assumptions

    2021, International Journal of Cardiology
    Citation Excerpt :

    Statistical significance was not achieved in this study published in 1974, paving the way for the subsequent trials. The beneficial effects of aspirin were initially shown in the secondary prevention setting in patients with a history of MI or unstable angina [3–5], and subsequently in patients with a history of stroke or transient ischemic attack as well [6,7]. A meta-analysis of 25 randomized trials looking at secondary prevention of cardiovascular disease (CVD) demonstrated a 15% reduction in vascular mortality and 30% reduction in non-fatal vascular events, consisting of MI and stroke, in patients allocated to antiplatelet therapy without a difference in the beneficial effects between patients allocated to lower dose (300–325 mg /day) versus higher dose of aspirin [8].

  • Long-term use of cardiovascular drugs challenges for research and for patient care

    2015, Journal of the American College of Cardiology
    Citation Excerpt :

    Although the average follow-up in RCTs is limited, these medications are often administered open-endedly over many years. Table 2(11,12,17,23–49) shows an overview of some landmark RCTs that demonstrated the efficacy of aspirin, statins, beta-blockers, and ACE inhibitors in post-MI (and stable CHD) patients. A good example of this problem is a meta-analysis published in 2010 on the use of statins as primary and secondary prevention, in which the median follow-up across 26 trials was 4.9 years (2).

  • Sudden cardiac death from the perspective of coronary artery disease

    2014, Mayo Clinic Proceedings
    Citation Excerpt :

    Treating all patients who have experienced MI with aspirin decreases all-cause mortality and has the additional benefit of reducing the likelihood of ischemic stroke and reinfarction through antiplatelet effects.94 In one early trial evaluating the role of aspirin in secondary prevention after MI, patients randomly assigned to aspirin for 1 year had an overall decrease in total mortality and a hospital readmission rate of 28% compared with those given a placebo (P<.05).95 β-Blockers also reduce all-cause mortality and the risk of reinfarction in the post-MI period and may decrease the rates of SCD by 40% to 55%.96

  • Antiplatelet Therapy

    2011, Preventive Cardiology: Companion to Braunwald's Heart Disease Expert Consult - Online and Print
View all citing articles on Scopus
View full text