Professors Tom Meade, Jan van Gijn, Bo Norrving and Lars Wallentin are the scientists responsible for first trials of low-dose daily aspirin to prevent coronary and cerebrovascular events. These scientists have been recognised with the International Aspirin Foundation’s Senior Science Award 2020.
Professors Lars Wallentin, Jan van Gijn, Bo Norrving and Tom Meade led four pivotal trials across Sweden, the Netherlands and the UK in the 1980s. Together, these trials – the Research Group on Instability in Coronary Artery Disease (RISC study), the Dutch TIA Trial, the Swedish Aspirin Low-dose Trial (SALT) and the Thrombosis Prevention Trial (TPT) – changed scientific understanding of the effectiveness and tolerability of low-dose aspirin as an antiplatelet agent and helped establish low-dose aspirin as a mainstay of antithrombotic therapy in the treatment of heart attack and stroke.
The group’s work began at a time when the role of thrombosis in cardiovascular events was known but it was not clear how best to prevent it while maintaining acceptable bleeding risks. Higher doses of aspirin had shown promise in preventing clots but at the expense of gastrointestinal toxicity, and although there was an emerging hypothesis that a low dose might be more effective, the field was still influenced by alternative thinking. As such, it took intellectual courage and scientific insight to design the trials which ultimately contributed to the prevention of countless coronary and cardiovascular events worldwide.
Professor Carlo Patrono, Chair of the International Aspirin Foundation’s Scientific Advisory Board said:
“We are delighted to recognise this group of international investigators. Lessons from their pioneering work have influenced the design of subsequent trials in other clinical settings and have contributed to establishing low-dose aspirin as a novel paradigm of antithrombotic therapy in both the cardiological and neurological fields.”
The Award Ceremony took place virtually on 16th November 2020.
Professor Bo Norrving
Prof Norrving reflects on the Swedish Low-dose Aspirin Trial (SALT), expanding on the data findings over four decades, giving an up to date perspective on the secondary prevention of low dose aspirin in stroke. Prof Norrving makes the point that this basic therapy should be globally available as recommended by the World Health Organisation.
Professor Jan van Gijn
Prof van Gijn discussed the optimal aspirin dose to reduce the risk of TIA’s or non-disabling brain ischaemia which led to the Dutch TIA trial. The trial proved 30mg was equal to 300mg in efficacy.
Professor Lars Wallentin
Prof Wallentin gave a presentation on low dose aspirin in acute coronary syndrome, and the findings of the RISC research group. The influence of this work was put into context with a 2020 review that showed the recent pharmacology interventions in acute coronary syndromes.
Professor Tom Meade
Prof Rothwell, who has worked closely with Prof Meade, gave the presentation on the two novel interventions in the Thrombosis Prevention Trial (TPT). The trial provided evidence that aspirin reduces non-fatal ischaemic heart disease. The important records kept from this trial have influenced work in aspirin prevention of cancer, particularly CRC.