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To the Editor: Dr Campbell and colleagues¹ conducted a systematic review of aspirin dose in prevention of cardiovascular disease. I believe that their use of the differences in bleeding rate observed in the post hoc analysis of the aspirin only group of the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) trial² warrants clarification.

On the assumption of 50 million patients taking aspirin in the United States, the authors state that "if the differences in major bleeding found in the aspirin-only group of the CURE trial are reflective of this population, daily treatment with 325 mg of aspirin would lead to an excess of more than 900 000 major bleeding events per year compared with a daily dose of 81 mg."¹ This is a very big "if" and hence a disproportionately hypothetical figure.

The analysis of the results of the CURE trial by Peters et al² was a retrospective subgroup . . . [Full Text of this Article]

Andrew Clegg, MBBS, BSc, MRCP
andrewpaulclegg@yahoo.co.uk
Department of Geriatric Medicine
Calderdale Royal Hospital
Halifax, United Kingdom

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