Individualised prediction of alternate-day aspirin treatment effects on the combined risk of cancer, cardiovascular disease and gastrointestinal bleeding in healthy women
Key result
Alternate-day low-dose aspirin is ineffective or harmful in most healthy women, but selective treatment of women ≥65 years may improve net benefit with a 15-year NNT of 29 (95% CI 12-102).
Why the study?
Does alternate-day aspirin improve the combined risk of cancer, cardiovascular disease, and gastrointestinal bleeding in healthy women?
Population
27,939 healthy women with baseline plasma samples in the Women's Health Study
Comparison
Aspirin 100 mg alternate-day vs Placebo
Design
Cohort, randomised
Follow-up
15-year
Authors
Discussion
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Implication
May refine aspirin primary prevention via risk stratification in women; leaves open prospective validation before clinical adoption.
Study Design
Type
RCT (n=27,939)
Randomization
Randomised
Structured PICO
Does alternate-day aspirin improve the combined risk of cancer, cardiovascular disease, and gastrointestinal bleeding in healthy women?
P
Population
27,939 healthy women followed for 15 years to evaluate the absolute risk reduction of CVD, cancer, and major gastrointestinal bleeding by alternate-day aspirin.
I
Intervention
Aspirin 100 mg alternate-day
C
Comparator
Placebo
O
Outcome
Combination of cardiovascular disease, cancer, and major gastrointestinal bleedingcomposite
Main Result
Number Needed to Treat: 29 (95% CI 12–102)
Number Needed to Treat: 29
Alternate-day low-dose aspirin is ineffective or harmful for primary prevention in most healthy women due to bleeding risks, but may offer a net benefit in women aged 65 and older.
Cite This Study
Kruijsdijk et al. (2014) conducted an RCT in Primary prevention of cancer and cardiovascular disease (n=27,939). Aspirin vs. Placebo was evaluated on Combination of CVD, cancer and major gastrointestinal bleeding (NNT 29, 95% CI 12-102). Alternate-day low-dose aspirin is ineffective or harmful in most healthy women, but selective treatment of women ≥65 years may improve net benefit with a 15-year NNT of 29 (95% CI 12-102).