Indication: Cardiovascular disease (in diabetics)
Source: BMJ, October 16, 2008;337:a1840.
Research: The purpose of this study was to determine whether aspirin and antioxidant therapy, combined or alone, are more effective than placebo in reducing the development of cardiovascular events in patients with diabetes mellitus and asymptomatic peripheral arterial disease. Researchers from the University of Dundee, Glasgow Royal Infirmary and other sites in Scotland collaborated in the Prevention of Progression of Arterial Disease and Diabetes (POPADAD) trial, where patients were randomly assigned 100 mg aspirin plus antioxidant (n=320), aspirin tablet plus placebo capsule (n=318), placebo tablet plus antioxidant capsule (n=320) or placebo tablet plus placebo capsule (n=318).
Results: No evidence was found of any interaction between aspirin and antioxidant. Overall, 116 of 638 primary events occurred in the aspirin groups compared with 117 of 638 in the no aspirin groups (18% vs. 18%). Forty-three deaths from coronary heart disease or stroke occurred in the aspirin groups compared with 35 in the no aspirin groups (7% vs. 6%). Among the antioxidant groups, 117 of 640 (18%) primary events occurred compared with 116 of 636 (18%) in the no antioxidant groups. Forty-two (7%) deaths from coronary heart disease or stroke occurred in the antioxidant groups compared with 36 (6%) in the no antioxidant groups. Researchers believe this trial provides no evidence to support the use of aspirin or antioxidants in primary prevention of cardiovascular events and mortality in the population with diabetes studied.