March 1, 2000
Aspirin for the primary prevention of stroke and other major vascular events: meta-analysis and hypotheses.
Key result
Aspirin for primary prevention had no significant effect on stroke (RR 1.08; 95% CI 0.95-1.24), but decreased myocardial infarction (RR 0.74; 95% CI 0.68-0.82) and increased intracranial hemorrhage.
Why the study?
Does aspirin reduce stroke and other major vascular events when given for primary prevention to persons without clinically recognized vascular disease?
Population
52,251 participants without clinically recognized vascular disease pooled from 5 randomized trials of…
Comparison
Aspirin 75 to 650 mg/d vs Control (implied from randomized trials)
Design
Meta-analysis, Randomized clinical trials
Follow-up
average 4.6 years
Authors
Discussion
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Implication
Aspirin warrants caution for routine primary prevention due to ICH risk without stroke benefit; extends evidence that net gains are limited to secondary prevention.
Study Design
Type
Meta-Analysis (n=52,251)
Structured PICO
Does aspirin reduce stroke and other major vascular events when given for primary prevention to persons without clinically recognized vascular disease?
P
Population
52,251 participants without clinically recognized vascular disease (low intrinsic risk) pooled from 5 randomized trials of primary prevention
I
Intervention
Aspirin 75 to 650 mg/d
C
Comparator
Control (implied from randomized trials)
O
Outcome
Strokehard clinical
Main Result
Effect estimate: RR 1.08 (95% CI 0.95-1.24)
In primary prevention, aspirin does not significantly reduce stroke risk but decreases myocardial infarction, while increasing the risk of intracranial hemorrhage.
Cite This Study
Hart et al. (2000) conducted a meta-analysis in Persons without clinically recognized vascular disease (n=52,251). Aspirin was evaluated on Stroke (RR 1.08, 95% CI 0.95-1.24). Aspirin for primary prevention had no significant effect on stroke (RR 1.08; 95% CI 0.95-1.24), but decreased myocardial infarction (RR 0.74; 95% CI 0.68-0.82) and increased intracranial hemorrhage.