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Aspirin for Asymptomatic Carotid Artery Stenosis
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
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•Type with double-spacing
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Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
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TO THE EDITOR:
Cote and colleagues [1] present strong evidence that aspirin, 325 mg/d, does not effectively prevent ischemic events in asymptomatic patients with high-grade (≥ 50%) carotid artery stenosis [1].
In a prospective, double-blind trial [2], we showed that aspirin treatment slows the growth of carotid plaque in a dose-dependent fashion; a dose of 900 mg/d was more efficient than 50 mg/d [2]. Twenty-seven asymptomatic patients with 104 small carotid atheroma (<50% lumen narrowing) received aspirin for 1 year; during that period they were examined with a high-resolution ultrasound duplex system. The change in plaque area was significantly different for the treatment groups: Average plaque size remained the same after treatment with 900 mg of aspirin daily but increased markedly after treatment with 50 mg of aspirin daily (P = 0.011). There were significantly more lesions that showed progression in the 50-mg group than in the 900-mg group. Ultrasonographically proven disappearance of a lesion was noted only in the 900-mg group.
We therefore agree with Cote and colleagues that a higher aspirin dose may have a beneficial effect.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
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