Use of Low-Dose Aspirin in Primary Prevention of Cardiovascular Events Not Recommended

The use of low-dose aspirin in the primary prevention of cardiovascular events in healthy individuals with asymptomatic atherosclerosis is currently not warranted, according to the lead researcher of a large "real-world" study presented at the European Society of Cardiology (ESC) 2009 Congress.

In the randomized trial of 3350 subjects deemed at high risk for cardiovascular and cerebrovascular events because of a low ankle-brachial index (ABI) (<0.95), aspirin had absolutely no effect on reducing events compared with placebo, Dr Gerry Fowkes (University of Edinburgh, Scotland) reported on behalf of the Aspirin for Asymptomatic Atherosclerosis (AAA) trialists. However, aspirin did increase the risk of major hemorrhage. The bleeding effect "is a real obstacle," Fowkes told heartwire . "I don't think the evidence is convincing enough as yet that aspirin should be used routinely in the general population."

At the same conference, German researchers stated that routine use of low-dose aspirin in primary prevention of cardiovascular events with type 2 diabetes should be revised and may be harmful. Their comments came from results from two trials (Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes and Prevention of Progression of Arterial Disease and Diabetes). Both failed to find any efficacy from aspirin use.

Steve - the evidence continues to mount against the use aspirin for CVD prevention in healthy and diabetic individuals.