Cardiovascular Diseases Clinical Trial
To analyze existing data from the Physicians Health Study (PHS), a randomized primary prevention trial of low-dose aspirin and beta carotene conducted among 22,071 U.S. male physicians, to address questions concerning aspirin and cardiovascular (CV) disease that could not adequately be addressed during the randomized aspirin period.
DESIGN NARRATIVE:
The aspirin component of the trial was terminated on January 25, 1988, due to a demonstrated
benefit of aspirin on myocardial infarction. At that time, however, the number of strokes
and CV deaths experienced by trial participants was inadequate to definitively evaluate
these endpoints. The beta carotene component of the trial continued uninterrupted until its
scheduled termination in December, 1996. During this period detailed information continued
to be collected on post-trial aspirin use through annual questionnaires. As of October,
1995, the number of deaths, including cardiovascular deaths, had increased fourfold from
that in the randomized period, and the number of strokes had increased 3.5 times. The
investigators used data from both the randomized aspirin period and the observational period
following the trial to assess the impact of aspirin use on cardiovascular and total
mortality, and the long-term impact of aspirin use on subsequent stroke and MI. The methods
included analyses of both randomized aspirin assignment and of time-varying aspirin use, as
assessed on the annual questionnaires. Because of the potential for bias, the propensity for
aspirin use, particularly during the observational period was taken into account. Analyses
included use of proportional hazards models allowing for both time-varying effects of
aspirin use and controlling for time-varying confounders, as well as more complex procedures
using causal modeling.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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