Key result
In contemporary trials, aspirin for primary prevention slightly reduced major adverse cardiovascular events (RR 0.93) but significantly increased major hemorrhage (RR 1.37) with no mortality benefit.
Why the study?
To compare the benefits and harms of aspirin for primary prevention before and after widespread use of statins and colorectal cancer screening.
Does aspirin reduce vascular events or cancer mortality in adults without prior vascular disease in the modern era of statin use and cancer screening?
Population
Patients in older trials (95,456 for CV prevention, 25,270 for cancer mortality) and four newer trials (61,604)
Comparison
Aspirin vs control in contemporary studies (recruited 2005 onward) vs older studies (1978 to 2002)
Design
Meta-analysis comparing contemporary random-effects models with previous individual patient meta-analyses
Authors
Loading...
Aspirin should not be used routinely for primary prevention; confirms net harm from major hemorrhage without mortality benefit in the statin era.
Meta-Analysis (n=157,060)
Does aspirin reduce vascular events or cancer mortality in adults without prior vascular disease in the modern era of statin use and cancer screening?
Relative Risk: 0.93 (95% CI 0.86–0.99)
Absolute Risk Reduction: 0.33%
Number Needed to Treat: 263
In the modern era of widespread statin use and cancer screening, aspirin for primary prevention does not reduce non-fatal MI or cancer death, provides no mortality benefit, and significantly increases major hemorrhage.
Moriarty et al. (2019) conducted a meta-analysis in Cardiovascular disease (primary prevention) (n=157,060). Aspirin vs. Placebo was evaluated on Major adverse cardiovascular events (MACE) (RR 0.93, 95% CI 0.86-0.99). In contemporary trials, aspirin for primary prevention slightly reduced major adverse cardiovascular events (RR 0.93) but significantly increased major hemorrhage (RR 1.37) with no mortality benefit.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: