Novel biomarkers for cardiovascular risk, such as coronary artery calcium scoring and lipoprotein(a), can help identify specific patient groups who may benefit from low-dose aspirin for primary prevention.
Can novel biomarkers identify specific patient groups who would derive greater benefit than harm from low-dose aspirin for primary prevention of cardiovascular disease?
While routine aspirin use for primary prevention is no longer recommended due to bleeding risks, selective use guided by novel imaging and laboratory biomarkers may optimize the risk-benefit ratio for individual patients.
Low-dose aspirin has a well-established role in secondary prevention of cardiovascular disease but use in primary prevention remains uncommon due to limited evidence of benefit and risk of adverse effects such as bleeding. While benefit of aspirin in primary prevention may not outweigh risk in the general population, it may still be appropriate for particular groups in which benefit would be greater. Novel biomarkers for cardiovascular risk can help identify these groups. These include imaging markers such as coronary artery calcium scoring and carotid plaque assessment, and laboratory markers such as lipoprotein(a) and high sensitivity C-reactive protein. Use of these biomarkers for more effective risk stratification can delineate groups of patients with greater potential benefit from aspirin and help guide risk-benefit conversations regarding primary prevention.
Lewontin et al. (Fri,) conducted a review in Cardiovascular disease. Low-dose aspirin was evaluated. Novel biomarkers for cardiovascular risk, such as coronary artery calcium scoring and lipoprotein(a), can help identify specific patient groups who may benefit from low-dose aspirin for primary prevention.