Aspirin Lowers Stroke Risk in Peripheral Artery Disease

May 13 -- TUESDAY, May 12 (HealthDay News) -- There haven't been enough studies to tell whether aspirin reduces the risk of heart attack and death for people with the blocked leg blood vessel condition called peripheral arterial disease, but it does cut the incidence of stroke, researchers report.

The finding comes from a meta-analysis of the not-too-many studies of aspirin use with peripheral arterial disease (PAD); it appears in the May 13 issue of the Journal of the American Medical Association.

It's not clear why PAD has been a neglected subject, said study co-author Dr. Mori J. Krantz, an associate professor of medicine at the University of Colorado. "PAD is the unloved stepchild of atherosclerosis, in that it has been understudied."

The degree of neglect was evident in numbers cited in the report. Studies of aspirin therapy in other kinds of atherosclerosis have been numerous. But the largest of the 18 studies of PAD cited in the report included just 1,276 people. The total of all the people in those studies was 5,269.

And 15 of those 18 studies were done more than 10 years ago, said Dr. Mary McGrae McDermott, a professor of medicine at the Northwestern University Feinberg School of Medicine and co-author of an accompanying editorial. "How relative they are to the PAD patient today is not clear."

Overall, those studies found a 12 percent reduction in all cardiovascular events among patients receiving aspirin therapy, compared to those who were not -- a number that did not reach statistical significance. There was no significant reduction in the death rate or incidence of heart attacks, but the incidence of nonfatal stroke was 34 percent lower in the aspirin-taking group.

"We found no evidence of harm or increased bleeding risk with aspirin," Krantz said. "We think that aspirin, for the most part, is a good treatment for atherosclerosis."

"The fact that a statistically significant reduction was not found has a lot to do with the fact that the studies were clinically underpowered," McDermott said. "Antiplatelet therapy should be used for atherosclerosis, and aspirin is certainly the cheapest antiplatelet therapy for PAD."