Low-dose aspirin is suggested for primary cardiovascular prevention in patients at high cardiovascular risk (≥2 major events per 100 person-years) without increased bleeding risk.
Although the use of oral anticoagulants (vitamin K antagonists) has been abandoned in primary cardiovascular prevention due to lack of a favorable benefit-to-risk ratio, the indications for aspirin use in this setting continue to be a source of major debate, with major international guidelines providing conflicting recommendations. Here, we review the evidence in favor and against aspirin therapy in primary prevention based on the evidence accumulated so far, including recent data linking aspirin with cancer protection. While awaiting the results of several ongoing studies, we argue for a pragmatic approach to using low-dose aspirin in primary cardiovascular prevention and suggest its use in patients at high cardiovascular risk, defined as ≥2 major cardiovascular events (death, myocardial infarction, or stroke) projected per 100 person-years, who are not at increased risk of bleeding.
Halvorsen et al. (Tue,) conducted a review in Primary cardiovascular disease prevention. Aspirin was evaluated. Low-dose aspirin is suggested for primary cardiovascular prevention in patients at high cardiovascular risk (≥2 major events per 100 person-years) without increased bleeding risk.