Aspirin and primary prevention: heartwire collection

Prevention

Racial differences persist in aspirin use for primary prevention

2 COMMENTS - Dec 16, 2010 13:30 EST

Racial disparities persist in the use of aspirin for the primary prevention of coronary heart disease, new data from MESA show. And although guidance on the use of aspirin for primary prevention is now less clear-cut than when this study was performed, that doesn't change the overall message, say the authors.

Medscape Medical News

New guidelines on primary stroke prevention from AHA/ASA

3 COMMENTS - Dec 3, 2010 11:00 EST

In a first update since 2006, the authors outline specific, evidenced-based strategies to reduce the risk of a first stroke.

Acute Coronary Syndromes

Aspirin paradox investigated in TIMI database

9 COMMENTS - Oct 13, 2010 15:30 EDT

The idea that prior aspirin use by those who develop an ACS may actually predispose to worse outcomes does not appear to be a true phenomenon, a new study suggests.

Prevention

New statement urges caution for primary-prevention aspirin in diabetics

24 COMMENTS - Jun 3, 2010 17:00 EDT

A new statement from the AHA, ACC, and ADA says that aspirin for the primary prevention of cardiovascular disease is "reasonable" in patients with diabetes who are at high risk for cardiovascular events. The new recommendations are more cautious than those previously published.

Prevention

More heat for aspirin in new primary-prevention meta-analysis: "Creativity" needed to determine who will benefit

7 COMMENTS - Mar 25, 2010 15:00 EDT

This latest meta-analysis adds in the JPAD, POPADAD, and AAA trials to the 2009 Aspirin Treatment Trialists' Collaboration and reached very similar conclusions: aspirin's benefits in primary prevention are modest and substantially offset by its risks.

Brain/Kidney/Peripheral

AAA: Aspirin not warranted in healthy subjects with low ABI, based on population screening

6 COMMENTS - Mar 2, 2010 16:00 EST

Authors of the study say their study does not rule out a role for ankle/brachial index screening in the clinic or for other CVD drugs to reduce risk in asymptomatic subjects. But for aspirin and for populationwide screening, the study raises some questions.

Prevention

Aspirin's US REACH: 25% of secondary-prevention patients not treated

2 COMMENTS - Feb 9, 2010 16:30 EST

A new registry analysis should remind physicians to step up use of aspirin in patients proven to benefit but also gives a snapshot of aspirin use in primary prevention that may prove helpful when results come in from the large trials in this group.

ADA exalts HbA<sub>1c</sub><sub> </sub>for diabetes diagnosis, updates aspirin recommendations

Lipid/Metabolic

ADA exalts HbA_1cfor diabetes diagnosis, updates aspirin recommendations

11 COMMENTS - Jan 20, 2010 12:45 EST

In new guidelines from the American Diabetes Association, elevated glycosylated hemoglobin can, for the first time, suffice for a diagnosis of diabetes; the recommendations also tighten up on the age criteria for prescribing aspirin for primary prevention.

Features

Mounting debate over aspirin use in primary prevention should prompt new talks with patients

10 COMMENTS - Dec 9, 2009 08:30 EST

The year kicked off with some rosy recommendations from the USPSTF, but a steady accumulation of studies suggest that aspirin's risks may eclipse its benefits in preventing initial cardiac and cerebrovascular events—most strikingly, a report from the same group that bolstered the primary-prevention case for aspirin in the first place. Everyone agrees: it's time to talk to your patients about aspirin.

Prevention

No benefits of aspirin for primary prevention in diabetics, meta-analysis suggests

7 COMMENTS - Nov 10, 2009 17:15 EST

Most guideline documents recommend aspirin for primary prevention in people with diabetes, but a new meta-analysis has found no benefit of the widely used drug across a range of different cardiovascular end points. The results speak to the need for dedicated randomized trials, investigators say.

Prevention

Experts question routine aspirin for patients with type 2 diabetes

3 COMMENTS - Sep 8, 2009 12:30 EDT

Not all patients with type 2 diabetes respond in the same way to aspirin, and its routine use in the primary prevention of cardiovascular events in this population needs careful evaluation in large randomized controlled trials, experts say.

Prevention

Use of low-dose aspirin in primary prevention of cardiovascular events not recommended

7 COMMENTS - Aug 30, 2009 16:00 EDT

The routine use of aspirin for the prevention of vascular events in the general population deemed at risk because of an abnormal ABI is not warranted, as the danger of bleeding outweighs any potential benefit.

Prevention

Meta-analysis questions use of aspirin in primary prevention

13 COMMENTS - Jun 3, 2009 10:15 EDT

Results of a new meta-analysis "do not seem to justify general guidelines advocating the routine use of aspirin in all healthy individuals above a moderate level of risk for coronary heart disease."

Brain/Kidney/Peripheral

No significant reduction of CV events with aspirin in peripheral artery disease

May 13, 2009 16:30 EDT

A meta-analysis of trials assessing the effects of aspirin with or without dipyridamole in patients with PAD finds no significant benefit in reducing overall cardiovascular events, although there was a significant reduction in stroke as a secondary end point.

Lipid/Metabolic

JPAD: No effect of aspirin primary-CV-event prevention in diabetics

13 COMMENTS - Nov 9, 2008 21:30 EST

Low-dose aspirin didn't cut the risk of cardiovascular events but may have reduced CV mortality, a secondary end point, in the randomized but open-label trial conducted in Japan; clinical events were unexpectedly few, compromising the study's statistical power. (Ogawa H et al. JAMA 2008; 300:2180-2181. American Heart Association 2008 Scientific Sessions.)

Lipid/Metabolic

Aspirin: Should it be used for primary prevention in diabetics?

6 COMMENTS - Oct 17, 2008 13:45 EDT

A new study, POPADAD, has found no evidence that aspirin or antioxidants are of any benefit in the primary prevention of cardiovascular events in diabetic patients with asymptomatic peripheral arterial disease. The authors and accompanying editorialist say guidelines should be changed; others say more evidence is needed. (Belch Jet al. BMJ; published online before print October 16, 2008.)

Prevention

Aspirin reduces nonfatal MI in studies of men, but not in trials dominated by women

Oct 22, 2007 11:00 EDT

A meta-analysis combining 23 trials indicates that aspirin reduces the risk of nonfatal MI but not fatal MI. Risk reduction was greater in trials dominated by men, whereas in studies in which one-third of the participants were women, aspirin had no significant effects on MI risk. (Yerman T et al. BMC Med 2007; 5:29.)

Prevention

Low-dose aspirin best for CV disease prevention

1 COMMENT - May 8, 2007 16:00 EDT

Currently available clinical data do not support the routine long-term use of aspirin dosages greater than 75 to 81 mg/day in the setting of cardiovascular disease prevention, a new review confirms. (Campbell CL et al. JAMA 2007; 297:2018-2024.)

News

Cost-analysis study of aspirin for CVD prevention finds it useful for older women, but not for younger ages

1 COMMENT - Feb 14, 2007 16:45 EST

Researchers did a cost-effectiveness study of aspirin for the primary prevention of CVD events in women and found that it costs $13 000 for each additional quality-adjusted life-year for an older woman. However, for the younger ages, the QALY was up to $50 000 and the risk of harm exceeded potential benefits. (Pignone M et al. Arch Intern Med 2007; 167:290-295.)

News

Aspirin prevents strokes in women, MIs in men, but bleeding risk high

Jan 17, 2006 18:00 EST

A sex-specific meta-analysis of aspirin for primary prevention has found that it reduces the risk of ischemic stroke in women, but not men, and MI in men, but not women. However, there is a price to pay in the form of increased bleeding for both sexes, and the decision on whether to give aspirin for primary prevention should be made on a case-by-case basis, say the researchers. (Berger JS et al. JAMA 2006; 295:306-313.)

News

Remainder of Women's Health Study published

Jul 5, 2005 16:00 EDT

The latest publication of this landmark study shows no overall effect of aspirin or vitamin E in the primary prevention of cancer and no effect of vitamin E in the primary prevention of cardiovascular disease. There was, however, the suggestion of a protective effect of aspirin against lung cancer. (Cook NR et al. Lee IM et al. JAMA 2005; 294:47-55, 56-65.)

News

Should everyone over the age of 50 take aspirin?

1 COMMENT - Jun 16, 2005 19:00 EDT

Drs Peter Elwood and Colin Baigent debate the rationale for daily aspirin in older adults with no known disease, as well as the shortcomings of such a strategy. (Elwood P et al. Baigent C. BMJ 2005; 330:1440-1443.)

News

Elderly should not be given aspirin for primary prevention

6 COMMENTS - May 19, 2005 19:00 EDT

A new epidemiological modeling study finds that the benefits of aspirin for primary prevention of cardiovascular disease in the elderly are likely offset by the risks of therapy. A prospective trial is thus needed in this age group to establish whether aspirin is beneficial or not, say the researchers. (Nelson M et al. BMJ 2005; published online before print May 19, 2005.)

News

Women's Health Study formally published: Discussion continues over results

Mar 30, 2005 17:30 EST

The Women's Health Study trial is formally published while debate rumbles on about why it failed to show a benefit of aspirin in primary prevention. (Ridker PM et al. N Eng J Med 2005; 352: 1293-1304.)

News

Experts begin to digest surprising aspirin findings from Women's Health Study

Mar 7, 2005 16:15 EST

Following the unexpected finding from the Women's Health Study that aspirin for primary prevention does not lower the risk of myocardial infarction or cardiovascular death in women, experts tried to make sense of the data. (American College of Cardiology 2005 Scientific Sessions.)