To the Editor: In their randomized controlled trial, Dr Fowkes and colleagues1 examined the use of aspirin for prevention of cardiovascular events in a population with low ankle brachial index (ABI). Based on the lack of benefit of aspirin in this study, the authors suggested that “using the ABI in the community to screen individuals free of cardiovascular disease for an ABI of 0.95 or less is unlikely to be beneficial if aspirin is the intervention of choice.” In his accompanying Editorial, Dr Berger2 went further and suggested that “these data do not support recommendations for ABI screening in an effort to ultimately reduce CVD [cardiovascular disease] event rates in patients at risk for peripheral artery disease.” I believe this is a misinterpretation of the data.
Joshua A. Beckman. Aspirin for Prevention of Cardiovascular Events in Individuals With Low Ankle Brachial Index. JAMA. 2010;303(21):2136–2137. doi:10.1001/jama.2010.697