Does ADAPTABLE Inform Aspirin Dosing for Secondary Prevention?

This transcript has been edited for clarity.

Michelle L. O'Donoghue, MD, MPH: Hi. I'm Dr Michelle O'Donoghue, reporting for Medscape. Today the first of our late-breaking clinical trials sessions aired at the 2021 virtual meeting of the American College of Cardiology. There was a lot of excitement about the presentation of the ADAPTABLE trial, and here to discuss the top-line results is Dr Schuyler Jones from Duke University. Welcome.

Schuyler Jones, MD: Thanks for having me, Michelle.

O'Donoghue: Could you walk our listeners through the rationale as well as the overall study design? Then we'll get into the findings.

Are the Results Actionable?

Jones: ADAPTABLE was a large pragmatic study, the first randomized controlled trial (RCT) in the United States using the PCORnet (the National Patient-Centered Clinical Research Network) infrastructure. We randomly assigned patients with established heart disease and at least one common "enrichment" (or risk) factor to receive 81 mg or 325 mg of aspirin daily and followed them for 26 months. We know that aspirin is the most commonly used medication for heart disease, yet despite some observational analyses and some RCT results from patients post–myocardial infarction (MI) or in those who have had percutaneous coronary intervention