No significant difference in primary efficacy and safety endpoints were found between enteric-coated and uncoated aspirin treatment among patients with established atherosclerotic CVD (ASCVD), according to data published in JAMA Cardiology. Current guidelines recommend enteric-coated aspirin to decrease gastrointestinal bleeding in secondary prevention of coronary artery disease despite studies suggesting that platelet inhibition is decreased with enteric-coated, compared with uncoated, aspirin formulations. To assess the impact of enteric-coated versus uncoated aspirin, Amber Sleem, DO, and colleagues conducted an analysis of the open-label, multicenter ADAPTABLE trial to assess the safety and efficacy of enteric-coated versus uncoated aspirin among participants who reported aspirin formulation at baseline (N=10,678). The researchers found no significant differences in the primary efficacy—including death, hospitalization for myocardial infarction, or hospitalization for stroke —or safety, including major bleeding endpoints, between the two cohorts. Despite a reduction in bleeding with enteric-coated aspirin being possible, further research is required to confirm whether these formulations improve outcomes in ischemia and bleeding among patients with ASCVD
