Key result
Low-dose aspirin remains a cornerstone of antithrombotic therapy across the cardiovascular risk continuum, with emerging evidence supporting its combination with low-dose anticoagulants and its repurposing for colorectal cancer chemoprevention.
Why the study?
To present the mechanistic rationale for recent trends in aspirin usage—early discontinuation, combination therapy, and oncologic repurposing—and discuss relevant clinical trials.
Answers are grounded in this paper and cite their sources.
This review emphasizes that despite recent trends to drop aspirin from antithrombotic regimens, it remains a foundational therapy when appropriately combined for cardiovascular prevention and has an emerging role in cancer chemoprevention.
During the past 20 years, we have witnessed the following trends in aspirin usage: (i) a “dropping” trend, characterized by the early discontinuation of low-dose aspirin from dual antiplatelet therapy or triple antithrombotic therapy (oral anticoagulation plus dual antiplatelet therapy in patients with atrial fibrillation) following an acute coronary syndrome or after percutaneous coronary intervention; (ii) a “combinatorial” trend, featuring the addition of a lower dose of a P2Y12 inhibitor or direct oral anticoagulant drug to low-dose aspirin for the long-term treatment of stable patients with atherosclerotic cardiovascular disease; and (iii) a “repurposing” trend, characterized by growing interest in the oncologic community to assess the chemopreventive effect of aspirin against certain types of cancers (particularly of the gastrointestinal tract), both as primary prevention and adjuvant therapy. The aim of this review is to present the mechanistic rationale underlying these trends, discuss the design and findings of trials testing novel treatments or new therapeutic applications of aspirin, and report on the ISTH Congress results on this topic.
No takes yet. Share an insight, caveat, or question.
Patrono et al. (2021) conducted a review in Atherosclerotic cardiovascular disease and colorectal cancer. Aspirin vs. Other antithrombotic agents or placebo was evaluated. Low-dose aspirin remains a cornerstone of antithrombotic therapy across the cardiovascular risk continuum, with emerging evidence supporting its combination with low-dose anticoagulants and its repurposing for colorectal cancer chemoprevention.
Synapse has enriched 10 related papers. Consider them for comparative context: