Aspirin for Primary Prevention of Cardiovascular Disease - a meta-analysis

Abstrakt

Platelet inhibition by aspirin reduces ischemic events but increases the risk of bleeding events. In patients with known cardiovascular disease (CVD), the benefits of aspirin to reduce further cardiovascular (CV) events significantly outweigh the risks of major bleeding and thus aspirin has since become a mainstay in secondary prevention of CVD. Yet, the role of aspirin in primary prevention of cardiovascular disease remains unclear. While updated guidelines from the American Heart Association and the U.S. Preventive Services Task Force do recommend aspirin for certain patient populations, guidelines by the European Society of Cardiology do not recommend aspirin for primary prevention of CVD. Recently, three major trials evaluating the use of aspirin in primary prevention of CVD were published. We therefore performed a meta-analysis, that additionally comprises the threelarge, recently published trials, ARRIVE, ASCEND and ASPREE. We aimed to produce a clinically relevant benefit-risk assessment of aspirin for primary prevention of cardiovascular disease