ATACSAntithrombotic Therapy in Acute Coronary Syndromes | |
| Authors: | (a) Cohen M, Adams PC, Parry G, Xiong J, Chamberlain D, Wieczorek I, Fox KAA, Chesebro JH, Strain J, Keller C, Kelly A, Lancaster G, Ali J, Kronmal R, Fuster V
(b) Cohen M, Parry G, Adams PC, Xiong J, Chamberlain D, Wieczorek I, Fox |
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| Titles: | (a) Combination antithrombotic therapy in unstable rest angina and non-Q-wave infarction in nonprior aspirin users: primary end points analysis from the ATACS trial
(b) Prospective evaluation of a prostacyclin- sparing aspirin formulation and heparin/warfarin in aspirin users with unstable angina or non-Q wave myocardial infarction at rest |
| References: | (a) Circulation 1994;89:81-8
(b) Eur Heart J 1994;15:1196-203 |
| Disease: | Unstable angina pectoris, non-Q-wave MI |
| Purpose: | (a) To assess whether the combination of aspirin plus anticoagulation vs aspirin alone, when added to conventional antianginal therapy, reduces cardiac morbidity and mortality in non-prior aspirin users
(b) To compare two different formulations of aspirin in the prevention of recurrent angina |
| Study Design: | (a) Randomised, open, parallel-group
(b) Randomised, double-blind, parallel- group |
| Follow-up: | 12 weeks |
| Patients: | (a) 214 non-prior aspirin users, randomised as soon as possible after admission
(b) 144 prior aspirin users (72 controlled- release and 72 conventional aspirin) |
| Treatmentregimen: | (a) Aspirin, 162.5 mg/day; or aspirin, 162.5 mg/day, plus heparin, 100 iv bolus, followed by infusion for 3-4 days, followed by aspirin, 162.5 mg/day, plus warfarin (international normalised ratio 2-3)
(b) Controlled-release, prostacyclin-sparing asp |
| Results: | (a) At 14 days, total ischaemic events were significantly reduced in the combination group compared with aspirin significantly reduced in the combination group compared with aspirin alone (10.5% and 27%, p = 0.004), and this difference was maintained to 12 weeks (13% and 25%, p = 0.06). Bleeding complications were slightly more common with combination therapy
(b) Prostacyclin-sparing aspirin offers no clinical benefits over conventional aspirin |
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