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June 6, 2024European Heart Journal90 citationsOpen Access

Low-dose aspirin for the prevention of atherosclerotic cardiovascular disease

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CPCarlo Patrono

Key Points

  • Low-dose aspirin remains central to preventing atherothrombosis, while newer evidence also demonstrates chemopreventive effects against colorectal cancer.
  • Clinical review assesses thirty years of antiplatelet development, examining aspirin pharmacodynamics alongside aspirin-free regimens after percutaneous coronary intervention.
  • Shifting clinical priorities from pure efficacy toward safety highlight the need to balance bleeding risks and atherosclerotic cardiovascular disease prevention.

Abstract

Abstract During the past 30 years, several developments have occurred in the antiplatelet field, including the role of aspirin in primary prevention of atherosclerotic cardiovascular disease. There have been several attempts to develop antiplatelet drugs more effective and safer than aspirin and a shift in emphasis from efficacy to safety, advocating aspirin-free antiplatelet regimens after percutaneous coronary intervention. Evidence supporting a chemopreventive effect of low-dose aspirin against colorectal (and other digestive tract) cancer has also strengthened. The aim of this article is to revisit the role of aspirin in the prevention of atherothrombosis across the cardiovascular risk continuum, in view of developments in the antiplatelet field. The review will offer a clinical perspective on aspirin’s mechanism of action, pharmacokinetics, and pharmacodynamics. This will be followed by a detailed discussion of its clinical efficacy and safety.

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Carlo Patrono (2024) studied this question.

synapsesocial.com/papers/68e65d00b6db6435875eaf5chttps://doi.org/10.1093/eurheartj/ehae324
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