Several recent reports have called into question the benefits of daily aspirin use (see links below) in the prevention of cardiovascular disease. Now comes new questions about aspirin's effectiveness at preventing thromboembolism.

In April, a large randomized placebo-controlled trial was published in The Lancet, which explored the use of aspirin in preventing venous thromboembolism in patients undergoing surgery for hip replacement or arthroplasty (joint reconstruction).

A sample of greater than 17,000 patients from 170 hospitals in 4 countries was used to determine aspirin's safety and efficacy.

The study's authors declared that " ... there is now good evidence for considering aspirin routinely in a wide range of surgical and medical groups at high risk of venous thromboembolism."

Sounds Great, Doesn't It?

But hold on. Not so fast. A response to the study was published in the British Medical Journal (BMJ) in September, which challenges that conclusion.

Dan Quinlan and Ander Cohen, of the King's and St Thomas's School of Medicine and Dentistry in London did not have a problem with the data of the aspirin study, but rather in the interpretation of them. Rather than being a positive for the use of aspirin, they assert that the data actually shows a negative impact. BOLD4

Among their observations is the fact that:

• "Aspirin did not reduce vascular deaths, clearly disproving the assertion that aspirin saves lives."

• The use of aspirin along with heparin did not show any benefit versus the use of heparin alone, but did cause a 48% increase in certain patients' risk of excessive bleeding.

• They note that previous studies of the use of heparin alone showed reductions of thrombosis of greater than 60% and a mortality reduction of 21%, whereas the aspirin study in the Lancet only showed a 29% reduction in thrombosis and no reduction in mortality.

Using the same exact data, Quinlan and Cohen conclude that " ... the main outcomes of the trial are that aspirin did not reduce vascular deaths, had no significant effect on major non-fatal vascular events other than deep vein thrombosis, but did result in an excess of 6 per 1000 postoperative transfused bleeds."

Concerning the conclusions stated in the previous aspirin study, they say "Dangerous generalisations about the benefits of aspirin have been made that unfortunately may have dire consequences for patient care."

In a previous letter published in The Lancet in response to the initial aspirin study, Dr Martyn Parker of Peterborough District Hospital in the UK, states "Unfortunately the paper and media coverage exaggerated the benefits without taking into account fully the adverse events and the most important outcome, mortality." He notes that the study showed that aspirin increased wound complications and gastrointestinal bleeding.

Another letter by Quinlan and Cohen in The Lancet puts it in very simply by stating "A negative study is presented as a positive one."

Aside from the implications of this in regards to aspirin use, what does this type of controversy say about the accuracy or trustworthiness of the conclusions reached in ANY peer-reviewed scientific research?

British Medical Journal September 2, 2000;321:569

Dr. Mercola's Comments:

Possibly the most important lesson to glean from this report is to be very cautious about taking conclusions reached in study abstracts at face value. Often the data, when properly analyzed, does not support these conclusions. This happens even in the best and most well respected publications. If one is going to use aspirin for its anti-platelet blood thinning activity the best dose is probably a baby aspirin (82 mg) every other day. However, as studies like this are beginning to indicate, there are likely far better options than resorting to aspirin. Vitamin E would be one, as would the diet and a good exercise program. Regular use of garlic would also be useful as it contains antioxidants that protect the arteries from free radical damage. It also is a powerful source of organic sulfur to assist in metabolic detoxification. Garlic also impairs blood coagulation. Raw garlic would be the best at about three cloves per day, but decrease the dose if the odor becomes socially offensive, as this is probably a sign of overdose. Gingko biloba is the oldest surviving tree species on earth dating back over 300 million years. It not only produces improvement in age-related memory loss but it also has flavonoids and terpenoids, which inhibit or prevent blood clot formation. Additionally it has potent antioxidant properties. Related Articles: Another "Nail in the Coffin" for Daily Aspirin Use Aspirin May Cause More Harm Than Good Long Term Aspirin Use Leads To Cataracts Aspirin, Ace Inhibitor Combination May Be Dangerous