Equation Predicts Bleeding Risk of Aspirin for Prevention of Cardiovascular Disease

MedicalResearch.com Interview with:

Dr Vanessa Selak, MBChB, MPH, PhD, FAFPHM, FNZCPHMSenior Lecturer, Section of Epidemiology & BiostatisticsSchool of Population Health, Faculty of Medical and Health SciencesUniversity of Auckland

Dr. Selak

Dr Vanessa Selak, MBChB, MPH, PhD, FAFPHM, FNZCPHM
Senior Lecturer, Section of Epidemiology & Biostatistics
School of Population Health
Faculty of Medical and Health Sciences
University of Auckland

MedicalResearch.com: What is the background for this study?

Response: In order to determine the balance of benefits and harms of aspirin in primary prevention there’s a need to know an individual’s risk of CVD and their risk of a major bleed without aspirin.

We have lots of equations that can be used to determine, among people considering aspirin for primary prevention, an individual’s risk of CVD, but few bleeding risk equations that can be used to determine their risk of a major bleed.

We sought to develop a bleeding risk equation that can be used to determine the risk of a major bleed among people in whom aspirin is being considered for the primary prevention of CVD.

MedicalResearch.com: What are the main findings?

Response: We developed a bleeding risk equation that, when combined with the proportional effect of aspirin on major bleeds, can be used to determine, for an individual, the harm they would be likely to experience if they initiated aspirin for the primary prevention of CVD.  

MedicalResearch.com: What should readers take away from your report?

Response: The results from this paper can be used to provide an estimate of the risk of a major bleed among New Zealanders in whom aspirin is being considered for primary prevention.

The generalizability of the equations to non-New Zealand populations is unclear.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Out next step is to develop a calculator that integrates the benefits and harms of aspirin for primary prevention to make it easier for clinicians to determine in which of their patients the benefits of aspirin are likely to outweigh its harms. 

Citation:

Predicting Bleeding Risk to Guide Aspirin Use for the Primary
Prevention of Cardiovascular Disease A Cohort Study

Vanessa Selak, MBChB, PhD; Rod Jackson, MBChB, PhD; Katrina Poppe, PhD; Billy Wu, MPH; Matire Harwood, MBChB, PhD; Corina Grey, MBChB, MPH; Romana Pylypchuk, MSc; Suneela Mehta, MBChB, MPH; Andrew Kerr, MBChB, MD; Sue Wells, MBChB, PhD
Published: Ann Intern Med. 2019.
DOI: 10.7326/M18-2808

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