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A low ankle-brachial index (ABI; ratio of systolic pressure at the ankle to that in the arm; normal range, 1.1–1.4) is a marker for peripheral vascular disease. Scottish investigators used ABI to screen asymptomatic patients who might benefit from aspirin for primary prevention of adverse cardiovascular (CV) events. Patients who were receiving antiplatelet drugs were excluded.
A total of 3350 adults with ABI ≤0.95 (mean age, 62; 71% women; mean ABI, 0.86; 33% smokers) were randomized to receive aspirin (100 mg daily) or placebo. During a mean follow-up of >8 years, no between-group differences were observed for any adverse CV event, revascularization, or stroke (about 13.5 events occurred per 1000 person-years in each group), or for mortalit…