Coronary disease & ACSRandomised controlled trial
Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation
- Randomised controlled trial
- multicentre
- double-blind
- placebo-controlled
- stopped early
- Stopped early at the advice of the independent data and safety monitoring board after a median follow-up of 2.2 years
Authors' conclusion
Among patients with chronic coronary syndrome at high atherothrombotic risk who were receiving an oral anticoagulant, the addition of aspirin led to a higher risk of cardiovascular death, myocardial infarction, stroke, systemic embolism, coronary revascularization, or acute limb ischemia than placebo, as well as higher risks of death from any cause and major bleeding.
Study context
- Population
- Patients in France with chronic coronary syndrome, previous stent (>6 months before enrollment), high atherothrombotic risk, on long-term OAC
- Participants
- 872 patients
- Comparison
- Aspirin vs placebo on top of OAC
- Aspirinn = 433
- Placebon = 439reference
- Primary endpoint
- Composite of:
- CV death
- MI
- Stroke
- Systemic embolism
- Coronary revascularization
- Acute limb ischemia
- Follow-up
- Median 2.2 years
Primary result
As reported in the abstract
Adjusted hazard ratio
1.53
95% CI 1.07–2.18
P = 0.02
Events by treatment group
Aspirin vs Placebo
adjusted HR 1.53 (95% CI 1.07–2.18); P = 0.02
Further findings
| Outcome | Aspirin | Placebo | adjusted HR (95% CI) | P value | |
|---|---|---|---|---|---|
| All-cause death | 13.4% | 8.4% | 1.72 (1.14–2.58) | P = 0.01 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Safety
| Outcome | Aspirin | Placebo | adjusted HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Major bleeding (key safety outcome) | 10.2% | 3.4% | 3.35 (1.87–6.00) | P < 0.001 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
events
| Outcome | Aspirin | Placebo | Estimate | P value |
|---|---|---|---|---|
| Serious adverse events (number reported) | 467 | 395 |
Original publication
Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation. N Engl J Med. Published 31 August 2025. doi:10.1056/nejmoa2507532
Summarised from the published abstract; every number is checked against it