Aspirin Linked to Lower Risk for CV Events in Primary Prevention

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Based on data from 13 trials with 164,225 participants, increased risk for major bleeding also noted.
Based on data from 13 trials with 164,225 participants, increased risk for major bleeding also noted.

(HealthDay News) -- For individuals without cardiovascular disease, use of aspirin is associated with a reduced risk for cardiovascular events and an increased risk for major bleeding, according to a meta-analysis published in the Journal of the American Medical Association.

Sean L. Zheng, BM, BCh, from Imperial College London, and Alistair J. Roddick, from King's College London, examined the correlation between aspirin use for primary prevention and cardiovascular events and bleeding. Data were included from 13 trials with 164,225 participants and 1,050,511 participant-years of follow-up.

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The researchers found that the median baseline risk for the primary cardiovascular outcome (composite of cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke) was 9.2%. Compared with no aspirin, aspirin use correlated with significant reductions in the composite cardiovascular outcome (57.1 vs 61.4 per 10,000 participant-years; hazard ratio, 0.89; absolute risk reduction, 0.38%) and correlated with an increased risk for major bleeding events (23.1 vs 16.4 per 10,000 participant-years; hazard ratio, 1.43; absolute risk increase, 0.47%).

The meta-analysis "demonstrates a general consistency of the newer studies with the previous studies of aspirin for primary prevention of cardiovascular events," write the authors of an accompanying editorial. "When applying these results to an individual patient, clinicians must consider other interventions in addition to aspirin, such as smoking cessation and control of blood pressure and lipid levels, to lower risk."

One editorial author disclosed financial ties to the pharmaceutical industry.

References

Zheng SL, Roddick AJ, et al. Association of Aspirin Use for Primary Prevention With Cardiovascular Events and Bleeding Events: A Systematic Review and Meta-analysis. JAMA. 2019;321(3):277-287. DOI:10.1001/jama.2018.20578

Gaziano JM. Aspirin for Primary Prevention Clinical Considerations in 2019. JAMA. 2019;321(3):253-255. DOI:10.1001/jama.2018.20577

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