ENSAYOS CLÍNICOS

ASPIRINA Y ENDARTERIECTOMIA CAROTIDEA

ESTUDIO ACE

Coordinador

D Wayne Taylor
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario

Patrocinio

National Institute of Neurologic Disorders and Stroke, NIH

Publicados los resultados en Junio de 1999

Aspirina

Antiplatelet agent; inhibits thromboxane A2

Endarterectomy, carotid (CEA)

Surgical therapy to remove atherosclerotic plaque in narrowed carotid arteries.

Purpose

To study the role of acetylsalicylic acid in patients undergoing carotid endarterectomy.

Design

Study Design: Randomized, double-blind, controlled trial of 2849 patients at 74 centers.

Inclusion Criteria: Patients scheduled for endarterectomy for arteriosclerotic disease and tolerant of 1300 mg acetylsalicylic acid daily.

Exclusion Criteria: Participation in another trial, requiring acetylsalicylic acid or other antiplatelet medication prior to study, recent disabling stroke, cardiac surgery in previous 30 days or scheduled for cardiac surgery in the next 30 days, failure to provide informed consent.

Patient Involvement: Patients were randomly assigned 81 mg (n=709), 325 mg (n=708), 650 mg (n=715), or 1300 mg (n=717) acetylsalicylic acid daily, started before surgery and continued for 3 months.

Primary Outcome: Stroke, myocardial infarction, and death measured at 30 days and 3 months.

Results

Patients treated with the two lower doses of aspirin before surgery had lower risk of stroke, heart attack or death at 30 days and three months following the surgery than did patients given the two higher doses. The combined rate of stroke, myocardial infarction and death was lower in the low-dose group than in the high-dose groups at 30 days (5.4% vs. 7.0%, p=0.07) and at 3 months (6.2% vs. 8.4%, p=0.03).

Source

Lancet 1999 June 26;353(9171):2179-84

Publications and Web Links

Article

Low-dose and high-dose acetylsalicylic acid for patients undergoing carotid endarterectomy: a randomised controlled trial. ASA and Carotid Endarterectomy (ACE) Trial Collaborators. Lancet. 1999 Jun 26;353(9171):2179-84.

Updated: 26-Sep-00