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• W2153728095 abstract "A recent meta-analysis of randomized controlled trials by the Antithrombotic Trialists’ Collaboration (ATC) highlighted the value of low-dose aspirin, 75–150 mg/day, in the secondary prevention of vascular events.1 However, based on six trials, the ATC reached the conclusion that low-dose aspirin is of uncertain net value in the primary prevention of a first event.1 Table 1 offers a re-analysis of the six primary prevention trials considered by the ATC. The data show that aspirin confers an additional risk of 59 bleeding episodes per 100,000 patient-years, a number needed to harm of approximately 1 in 2000 patientyears. The number of bleeds in the aspirin patients is 15% higher than in the non-aspirin patients, with respective mortalities of approximately four and five events per 100,000 patient-years. The evidence also suggests that the risk of fatal bleeds in the aspirin patients might be lower than in the non-aspirin patients. Perhaps aspirin might increase the risk of bleeds that are less serious than those which occur for other pathological reasons. However, the context is a trial which may underestimate the risks of undesirable effects of aspirin, given that individuals with contraindications to aspirin, such as a history of gastrointestinal (GI) ulcer, would be excluded. Mortality from GI bleeding has been estimated at 10%, and intracranial bleeds may have an even higher fatality rate. This emphasizes the need for caution with aspirin use to be exercised in the general population. In the six primary prevention trials, the percentage annual rate for serious vascular events was 0.51 for those in the aspirin group and 0.57 for those in the non-aspirin group. If 1 million individuals took low-dose aspirin for 1 year for primary prevention, an estimated 600 extra serious vascular events, heart attacks, strokes or deaths from these causes may be avoided. In the general population, there is the potential for this benefit to be larger; for example, ageing is" @default.
• W2153728095 created "2016-06-24" @default.
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• W2153728095 date "2009-12-01" @default.
• W2153728095 modified "2023-09-23" @default.
• W2153728095 title "Aspirin for the primary prevention of vascular events?" @default.
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• W2153728095 doi "https://doi.org/10.1016/j.puhe.2009.10.007" @default.
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