Aspirin Dose and Atherosclerosis in Patients With Heart Disease

NCT ID: NCT00272337

Last Updated: 2018-12-28

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

37 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-10-31

Study Completion Date

2009-06-30

Brief Summary

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The purpose of the study is to test higher versus lower doses of aspirin on markers of atherosclerosis in patients who have had a heart attack.

Detailed Description

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Aspirin reduces risks of heart attacks, strokes, and deaths from cardiovascular causes in patients who have survived a prior event as well as during an acute heart attack.

Low dose aspirin is sufficient to achieve complete inhibition of platelet aggregability, or stickiness, and this is the mechanism whereby aspirin prevents formation of blood clots.

Our research is designed to explore whether higher doses of aspirin provide additional benefits on markers of atherosclerosis.

Conditions

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Cardiovascular Diseases Atherosclerosis Myocardial Infarction

Keywords

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Cardiovascular diseases Aspirin Atherosclerosis Myocardial Infarction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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1

81 mg Aspirin

Group Type ACTIVE_COMPARATOR

Aspirin

Intervention Type DRUG

Dosage

2

162 mg Aspirin

Group Type ACTIVE_COMPARATOR

Aspirin

Intervention Type DRUG

Dosage

3

325 mg Aspirin

Group Type ACTIVE_COMPARATOR

Aspirin

Intervention Type DRUG

Dosage

4

650 mg Aspirin

Group Type ACTIVE_COMPARATOR

Aspirin

Intervention Type DRUG

Dosage

5

1300 mg Aspirin

Group Type ACTIVE_COMPARATOR

Aspirin

Intervention Type DRUG

Dosage

Interventions

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Aspirin

Dosage

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Age 40 to 80 years, inclusive.
2. Patients with stable coronary disease, with and without diabetes mellitus, defined by:

1. angiographic evidence of 70% or greater stenosis, or
2. previous percutaneous coronary intervention (PCI), or
3. coronary artery bypass graft (CABG), or
4. history of a MI, or
5. positive exercise test

Exclusion Criteria

1. Patients taking greater than 81mg aspirin daily.
2. Patients taking any of the following medications for less than 3 months, or who plan to take them for the first time during the next 3 months: ACE-inhibitors, angiotensin receptor blockers, calcium channel blockers, or statins.
3. Patients within 6 months of a coronary intervention, including PCI or CABG.
4. Patients with a planned coronary intervention.
5. Patients taking anti-platelet drugs such as clopidogrel or non-steroidal anti-inflammatory drugs (NSAIDs) or anticoagulant drugs such as warfarin.
6. Patients who are currently cigarette smokers.
7. Women patients who are pregnant, planning to become pregnant, nursing a child, or taking hormone replacement therapy.
8. Patients with any coagulation, bleeding or blood disorders.
9. Patients who are sensitive or allergic to aspirin.
10. Patients with documented history of any gastrointestinal disorders, including bleeding ulcers.
11. Patients with any evidence of cancer or kidney, liver, lung, blood, or brain disorders.
12. Patients with asthma, rhinitis, or nasal polyps.
13. Patients with any abnormal laboratory value or physical finding that, in the view of the responsible clinician, may interfere with interpretation of the trial results, be indicative of an underlying disease state, or compromise the safety.
14. Patients with Class IV heart failure.
15. Patients with severe aortic insufficiency, or aortic regurgitation.
16. Patients with hearing loss or tinnitus.
17. Patients with tremors which cause them not to be able to remain motionless for approximately 30 seconds.
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Bayer

INDUSTRY

Sponsor Role collaborator

Florida Atlantic University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Charles H Hennekens, MD, DrPH

Role: PRINCIPAL_INVESTIGATOR

Florida Atlantic University

Wendy R Schneider, MSN, CCRC

Role: STUDY_DIRECTOR

Florida Atlantic University

Locations

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Florida Cardiovascular Research

Atlantis, Florida, United States

Site Status

The Broward Heart Group, P.A.

Tamarac, Florida, United States

Site Status

Countries

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United States

References

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Williams A, Hennekens CH. The role of aspirin in cardiovascular diseases--forgotten benefits? Expert Opin Pharmacother. 2004 Jan;5(1):109-15. doi: 10.1517/14656566.5.1.109.

Reference Type BACKGROUND
PMID: 14680440 (View on PubMed)

Hennekens CH, Buring JE, Sandercock P, Collins R, Peto R. Aspirin and other antiplatelet agents in the secondary and primary prevention of cardiovascular disease. Circulation. 1989 Oct;80(4):749-56. doi: 10.1161/01.cir.80.4.749. No abstract available.

Reference Type BACKGROUND
PMID: 2676237 (View on PubMed)

Vane JR. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat New Biol. 1971 Jun 23;231(25):232-5. doi: 10.1038/newbio231232a0. No abstract available.

Reference Type BACKGROUND
PMID: 5284360 (View on PubMed)

Roth GJ, Stanford N, Majerus PW. Acetylation of prostaglandin synthase by aspirin. Proc Natl Acad Sci U S A. 1975 Aug;72(8):3073-6. doi: 10.1073/pnas.72.8.3073.

Reference Type BACKGROUND
PMID: 810797 (View on PubMed)

Patrignani P, Filabozzi P, Patrono C. Selective cumulative inhibition of platelet thromboxane production by low-dose aspirin in healthy subjects. J Clin Invest. 1982 Jun;69(6):1366-72. doi: 10.1172/jci110576.

Reference Type BACKGROUND
PMID: 7045161 (View on PubMed)

Reilly IA, FitzGerald GA. Inhibition of thromboxane formation in vivo and ex vivo: implications for therapy with platelet inhibitory drugs. Blood. 1987 Jan;69(1):180-6.

Reference Type BACKGROUND
PMID: 3790723 (View on PubMed)

Mustard JF, Packham MA. The role of blood and platelets in atherosclerosis and the complications of atherosclerosis. Thromb Diath Haemorrh. 1975 Jun 30;33(3):444-56.

Reference Type BACKGROUND
PMID: 1154306 (View on PubMed)

Mustard JF, Moore S, Packham MA, Kinlough-Rathbone RL. Platelets, thrombosis and atherosclerosis. Prog Biochem Pharmacol. 1977;13:312-25.

Reference Type BACKGROUND
PMID: 928433 (View on PubMed)

Mustard JF, Packham MA, Kinlough-Rathbone RL. Platelets and thrombosis in the development of atherosclerosis and its complications. Adv Exp Med Biol. 1978;102:7-30. doi: 10.1007/978-1-4757-1217-9_2. No abstract available.

Reference Type BACKGROUND
PMID: 356564 (View on PubMed)

Ikonomidis I, Andreotti F, Economou E, Stefanadis C, Toutouzas P, Nihoyannopoulos P. Increased proinflammatory cytokines in patients with chronic stable angina and their reduction by aspirin. Circulation. 1999 Aug 24;100(8):793-8. doi: 10.1161/01.cir.100.8.793.

Reference Type BACKGROUND
PMID: 10458713 (View on PubMed)

Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997 Apr 3;336(14):973-9. doi: 10.1056/NEJM199704033361401.

Reference Type BACKGROUND
PMID: 9077376 (View on PubMed)

Hennekens CH, Schror K, Weisman S, FitzGerald GA. Terms and conditions: semantic complexity and aspirin resistance. Circulation. 2004 Sep 21;110(12):1706-8. doi: 10.1161/01.CIR.0000142056.69970.DB. No abstract available.

Reference Type BACKGROUND
PMID: 15381661 (View on PubMed)

Steer KA, Wallace TM, Bolton CH, Hartog M. Aspirin protects low density lipoprotein from oxidative modification. Heart. 1997 Apr;77(4):333-7. doi: 10.1136/hrt.77.4.333.

Reference Type BACKGROUND
PMID: 9155612 (View on PubMed)

Wu R, Lamontagne D, de Champlain J. Antioxidative properties of acetylsalicylic Acid on vascular tissues from normotensive and spontaneously hypertensive rats. Circulation. 2002 Jan 22;105(3):387-92. doi: 10.1161/hc0302.102609.

Reference Type BACKGROUND
PMID: 11804997 (View on PubMed)

Oberle S, Polte T, Abate A, Podhaisky HP, Schroder H. Aspirin increases ferritin synthesis in endothelial cells: a novel antioxidant pathway. Circ Res. 1998 May 18;82(9):1016-20. doi: 10.1161/01.res.82.9.1016.

Reference Type BACKGROUND
PMID: 9598599 (View on PubMed)

Grosser N, Abate A, Oberle S, Vreman HJ, Dennery PA, Becker JC, Pohle T, Seidman DS, Schroder H. Heme oxygenase-1 induction may explain the antioxidant profile of aspirin. Biochem Biophys Res Commun. 2003 Sep 5;308(4):956-60. doi: 10.1016/s0006-291x(03)01504-3.

Reference Type BACKGROUND
PMID: 12927812 (View on PubMed)

Hennekens CH, Dyken ML, Fuster V. Aspirin as a therapeutic agent in cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 1997 Oct 21;96(8):2751-3. doi: 10.1161/01.cir.96.8.2751. No abstract available.

Reference Type BACKGROUND
PMID: 9355934 (View on PubMed)

Hennekens CH, Hollar D, Baigent C. Sex-related differences in response to aspirin in cardiovascular disease: an untested hypothesis. Nat Clin Pract Cardiovasc Med. 2006 Jan;3(1):4-5. doi: 10.1038/ncpcardio0420. No abstract available.

Reference Type BACKGROUND
PMID: 16391594 (View on PubMed)

Hetzel S, DeMets D, Schneider R, Borzak S, Schneider W, Serebruany V, Schroder H, Hennekens CH. Aspirin increases nitric oxide formation in chronic stable coronary disease. J Cardiovasc Pharmacol Ther. 2013 May;18(3):217-21. doi: 10.1177/1074248413482753. Epub 2013 Mar 21.

Reference Type DERIVED
PMID: 23524841 (View on PubMed)

Other Identifiers

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H08-36

Identifier Type: -

Identifier Source: org_study_id