A large cohort study suggests that aspirin prophylaxis only benefits people with a prior cardiovascular event

Conclusions In patients with stable coronary artery disease and hypertension, aspirin use was associated with reduced risk for adverse cardiovascular outcomes among those with prior ischemic events. Among patients with no prior ischemic events, aspirin use was not associated with a reduction in risk. COMMENT: The determining the risk/benefit ratio of prophylactic aspirin use for the prevention of cardiovascular events has become a complicated issue.  The current recommendations from the CDC http://www.cdc.gov/heartdisease/aspirin.htm recommend aspirin prophylaxis in those with prior cardiovascular events.  The data presented in this paper comports with this recommendation.  However, the CDC recommendations for those without known cardiovascular disease (men aged 45-79 and women aged 55-79) are rather vague in helping the clinician determine which of such patients would the benefit outweigh the risks of bleeding.  The current study concludes that even in those with known CAD, aspirin prophylaxis showed no benefit in the absence of a prior cardiovascular event.  One can reasonably conclude then that aspirin prophylaxis will be unlikely to benefit those individuals without a history of cardiovascular events.  
Source: Doc2Doc BMJ Cardiology - Category: Cardiology Authors: Source Type: forums