Abstract 13942: Do Geographic Trends in Aspirin Discharge Dose Alter Outcomes After STEMI and Primary PCI: Results From the HORIZONS-AMI Trial
Background Previous studies have suggested an association between higher aspirin dose and bleeding. We sought to examine the geographic differences in aspirin dosing post STEMI, and to determine any impact on patient outcomes.
Methods and Results We studied outcomes from the large scale, randomized trial HORIZONS-AMI. Of 760 pts enrolled in the US with known discharge aspirin dose, 262 (34.5%) had low dose aspirin (<200mg/day) and 65.5% the high dose. 2,152 (94.9%) of the 2,268 pts enrolled outside US (OUS) had low dose and only 5.1% the high dose (p<0.05 compared to US). Fig 1 shows 3 year outcomes by enrolment region and aspirin dose, significant p values are indicated. Aspirin dose was not associated with significant differences in the rates of death, stroke or reinfarction.
Conclusions Compared with pts enrolled OUS, US pts were more likely to have higher aspirin doses prescribed. Irrespective of aspirin dose, US patients had worse 3 year composite rates of death or reinfarction. High dose aspirin had more major bleeding regardless of the place of enrolment, and without any benefit in ischemic endpoints.
- © 2011 by American Heart Association, Inc.