12 Jun Aspirin for Primary Prevention of Cardiovascular Events
MedicalResearch.com Interview with:
J.L. Mehta, MD, PhD
Distinguished Professor of Medicine and Physiology and Biophysics
Stebbins Chair in Cardiology
University of Arkansas for Medical Sciences
Central Arkansas Veterans Healthcare System
Little Rock, AR 72205
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Aspirin is commonly used for primary prevention of cardiovascular disease events in a variety of subjects around the world. Recent studies, however, show that routine use of aspirin without assessment of risk for cardiovascular disease events may not be appropriate, and may even be harmful.
MedicalResearch.com: What should readers take away from your report?
Response: Based on analysis of 15 randomized controlled trials including 165,502 participants (aspirin n = 83,529, control n = 81,973), Based on extensive analysis, aspirin was associated with similar all-cause death, CV death and non-CV death, but a lower risk of nonfatal MI, and ischemic stroke. Aspirin was associated with a higher risk of major bleeding, intracranial bleeding, and major GI bleeding, with similar rates of fatal bleeding compared with the control subjects. Total cancer and cancer-related deaths were similar in both groups within the follow-up period of the study.
In conclusion, aspirin for primary prevention reduces nonfatal ischemic events but significantly increases nonfatal bleeding events.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Further studies could be done to estimate the risk-benefit ratio in the modern era when life-style modifications are being employed in a large percentage of population and many subjects take a variety of cardioprotective medications.
MedicalResearch.com: Is there anything else you would like to add?
Response: We believe that the decision to use aspirin for primary prevention should be tailored to the individual patient based on estimated ASCVD risk and perceived bleeding risk, as well as patient preferences regarding types of events prevented versus potential bleeding caused. When aspirin is used for primary prevention, a low dose (<100 mg/day) should be recommended.
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