Aspirin no benefit for those without CVD

According to a new study from the August issue of American Heart Journal, the benefit of aspirin to prevent cardiovascular events in subjects without clinical cardiovascular disease relative to the increased risk of bleeding is uncertain. 52,145 subjects were allocated to aspirin and 50,476 to placebo/control. Over a mean follow-up of 6.9 years, aspirin was associated with a reduction in major cardiac events (MCE). There was no significant reduction for myocardial infarction, stroke, ischemic stroke, or all-cause mortality. Aspirin was associated with hemorrhagic stroke and major bleeding. The number needed to treat to prevent 1 MCE over a mean follow-up of 6.9 years was 253, which was offset by the number needed to harm to cause 1 major bleed of 261. The current totality of evidence provides only modest support for a benefit of aspirin in patients without clinical cardiovascular disease, which is offset by its risk. For every 1,000 subjects treated with aspirin over a 5-year period, aspirin would prevent 2.9 MCE and cause 2.8 major bleeds.