March 17, 2009Annals of Internal Medicine

Aspirin for the Primary Prevention of Cardiovascular Events: An Update of the Evidence for the U.S. Preventive Services Task Force

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Why the study?

Does aspirin decrease coronary heart events, strokes, death from coronary heart events or stroke, or all-cause mortality in adults without known CVD?

Population

Adults without known cardiovascular disease (CVD)

Comparison

Aspirin vs Control

Design

Systematic_review

Authors

TWTracy WolffUniversity of North Carolina at Chapel Hill

Discussion

Member takes

Implication

Aspirin should not be used routinely for primary CVD prevention due to bleeding without mortality benefit; confirms meta-analyses and supports guideline restrictions.

Structured PICO

Does aspirin decrease coronary heart events, strokes, death from coronary heart events or stroke, or all-cause mortality in adults without known CVD?

Population

Adults without known cardiovascular disease (CVD)

Intervention

Aspirin

Comparator

Control

Outcome

Myocardial infarctions, strokes, and death (coronary heart events, strokes, death from coronary heart events or stroke, or all-cause mortality)hard clinical

Aspirin for primary prevention reduces MIs in men and ischemic strokes in women, but increases the risk of major bleeding without affecting mortality.

Limitations

New evidence on aspirin for the primary prevention of CVD is limited
The dose of aspirin used in the RCTs varied, which prevented the estimation of the most appropriate dose for primary prevention
Several of the RCTs were conducted within populations of health professionals, which potentially limits generalizability

Cite This Study

Tracy Wolff (2009) studied this question.

synapsesocial.com/papers/6a7f5cfaea270e40cde8fa0e https://doi.org/10.7326/0003-4819-150-6-200903170-00009

Topics

Dual antiplatelet therapy Cardiovascular prevention Women and heart disease

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Implication

Aspirin should not be used routinely for primary CVD prevention due to bleeding without mortality benefit; confirms meta-analyses and supports guideline restrictions.