The Clinical Impact of the ADAPTABLE Trial

Daily aspirin use for patients at risk for major cardiovascular event is a topic of high interest in the field of cardiology.

In the first episode of HCPLive’s newest podcast series Heart Trials, W. Schuyler Jones, MD, and Manesh Patel, MD, discussed findings from the ADAPTABLE trial that showed there to be little difference in safety between 81 mg and 325 mg aspirin among patients with atherosclerotic cardiovascular disease. Nevertheless, 42% of patients switched from the higher to the lower dose.

These results were presented as late-breaking data at this year’s American College of Cardiology (ACC) Virtual Sessions.

Led by Jones, the investigative team compared aspirin doses for patients who are likely to experience cardiovascular events and, potentially, death. He noted that many patients generally begin with 325 mg aspirin following an event and then drop to 82 mg.

“Seeing that variation, and seeing that you may actually have an effect if you can find the best dose to reduce heart attacks and deaths and balance bleeding, we decided to try to answer a simple question: what’s the best dose?”

Beyond the study’s findings, the clinical impact is certainly a relevant question. In other words, how might the study’s design and findings influence research and the field going forward?

Both Jones and Patel offered their thoughts on this question.

“More than anything, the process of the trial is important: can we do a pragmatic study on a limited budget in the United States in a relatively short period?” Jones opined.

Patel, who was not involved in ADAPTABLE, lauded the trial’s “democratization,” or its ability to effectively engage participants. He also believed the trial may influence the aspirin doses used in future clinical trials—especially considering the comparability between the 82 mg and 325 mg doses.

Listen to Episode 1 of Heart Trials below: