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To the Editor: The meta-analysis of randomized controlled trials of aspirin for the primary prevention of cardiovascular events by Dr Berger and colleagues¹ reported that aspirin decreased the incidence of myocardial infarction in men, but not in women. However, the aspirin dose in the 5 trials that included men ranged from 75 mg/d to 500 mg/d. The dose in the 3 trials that included women ranged from 50 mg/d (100 mg every other day) to 100 mg/d.

Rather than concluding that aspirin does not prevent myocardial infarction in women, it is more accurate to state that aspirin in doses of 100 mg/d or less is ineffective in preventing myocardial infarction in women. It is possible that a dose of 160 mg/d or more may be effective.²

Financial Disclosures: None reported.

James E. Dalen, MD, MPH
jamesdalen@yahoo.com
University of Arizona
Tucson

1. Berger JS, Roncaglioni MC, Avanzini F, et al. Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials. JAMA. 2006;295:306-313. FREE FULL TEXT 2. Dalen JE. Aspirin to prevent heart attack and stroke: what is the right dose? Am J Med. 2006;119:198-202. FULL TEXT | ISI | PUBMED

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;296:391.

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