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To the Editor: In their systematic review of aspirin dose for the prevention of cardiovascular disease, Dr Campbell and colleagues¹ conclude that currently available data do not support the routine long-term use of aspirin dosages greater than 75 mg/d to 81 mg/d in the setting of cardiovascular disease prevention. The definition of cardiovascular disease includes stroke, transient ischemic attack, and myocardial infarction. We agree with the authors that aspirin dosage in excess of 300 mg/d is not justified, but suggest the potential for better stroke prevention using aspirin dosage of 160 mg/d compared with 75 mg/d to 81 mg/d.

Of the 11 studies included in the review, the study by Peters et al² compared different aspirin dosages in patients with acute coronary syndrome. However, that article only reported the composite outcome of cardiovascular death, myocardial infarction, and stroke. The relationship between aspirin dosage and stroke incidence may be masked by . . . [Full Text of this Article]

George Kwok Chu Wong, MB ChB, FRCSEd(SN)
georgewong@surgery.cuhk.edu.hk
Division of Neurosurgery
The Chinese University of Hong Kong
Hong Kong

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