Aspirin Therapy for the Primary Prevention of Cardiovascular Disease: A Meta-analysis of Randomized Trials

Although the daily use of aspirin reduces the risks of myocardial infarction, stroke and vascular death in patients at high risk of developing vascular disease, the use of preventative aspirin therapy in patients with no history of cardiovascular disease is controversial. For this reason, we studied the benefits and risks of aspirin therapy in the primary prevention of cardiovascular disease, in particular for aspirin at low doses.On performing a meta-analysis of 4 randomized trials with low-dose aspirin therapy for primary prevention, the low-dose aspirin was found to significantly reduce the risk of myocardial infarction (summary odds ratio (OR), 0.64; 95% confidence interval (CI), 0.56 to 0.74). Though the all-cause mortality (summary OR, 0.94; 95% CI, 0.84 to 1.04) was not significantly affected by aspirin therapy, it significantly increased the risk of gastrointestinal bleeding (summary OR, 2.03; 95% CI, 1.55 to 2.65).These results suggest that low-dose aspirin therapy is beneficial in the primary prevention of myocardial infarction, but it increases the risk of gastrointestinal bleeding