Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: We very much agree with Dr Clegg's comment; our estimate of potential harm based on the use of different doses of aspirin was intended to be speculative. We included it in our review solely to highlight that the global implications for the routine use of different doses of aspirin may not be insignificant. The only way to know the true difference is through an adequately powered clinical trial comparing ~ 81 mg with ~ 325 mg of aspirin daily. We are not aware of any trial doing so in long-term cardiovascular disease prevention, although the ongoing Clopidogrel Optimal Loading Dose Usage to Reduce Recurrent EveNTs/Optimal Antiplatelet Strategy for InterventionS (CURRENT/OASIS 7) trials will compare this dose range of aspirin among 14 000 acute coronary syndrome patients for 30 days following a percutaneous coronary intervention.1
Campbell CL, Smyth S, Steinhubl SR, Montalescot G. Aspirin Dose and Cardiovascular Disease Prevention—Reply. JAMA. 2007;298(6):625-626. doi:10.1001/jama.298.6.625-c