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ACC: Aspirin, Clonidine Don't Affect Death, MI in Noncardiac Sx

Posted on Sun, Apr 06, 2014
ACC: Aspirin, Clonidine Don't Affect Death, MI in Noncardiac Sx

Two studies show no significant effect on these outcomes versus placebo

MONDAY, March 31, 2014 (HealthDay News) -- For patients undergoing noncardiac surgery at risk for vascular complications, administration of aspirin or clonidine has no significant effect on a composite of death or nonfatal myocardial infarction, according to two studies published online March 31 in the New England Journal of Medicine. This research was published to coincide with presentation at the annual meeting of the American College of Cardiology, held from March 29 to 31 in Washington, D.C.

Philip J. Devereaux, M.D., Ph.D., from McMaster University in Hamilton, Canada, and colleagues randomized 10,010 patients due to undergo noncardiac surgery at-risk of vascular complications to receive aspirin or placebo and clonidine or placebo. The researchers found that the primary outcome of a composite of death or nonfatal myocardial infarction at 30 days occurred in 7.0 percent of the aspirin group and 7.1 percent of the placebo group (hazard ratio [HR] in the aspirin group, 0.99; P = 0.92). Major bleeding was more common in the aspirin group (HR, 1.23).

In a second study, Devereaux reported the results from the clonidine trial, involving 10,010 patients undergoing noncardiac surgery. The researchers found that the primary outcome was not significantly different in the clonidine and placebo groups (HR with clonidine, 1.08; P = 0.29). In the clonidine group, significantly more patients experienced clinically important hypotension (HR, 1.32) and there was an increased rate of nonfatal cardiac arrest (HR, 3.20).

"Administration of low-dose clonidine in patients undergoing noncardiac surgery did not reduce the rate of the composite outcome of death or nonfatal myocardial infarction," Devereaux and colleagues write in the second study.

The second study was partially funded by Boehringer Ingelheim, which provided the clonidine study drug. Bayer provided the aspirin study drug.

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