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Vascular Disease Prevention Benefits of Aspirin Uncertain

Last Updated: May 29, 2009.

 

As primary prevention, it reduces heart attacks but increases bleeds, study suggests

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The benefits of using aspirin in the primary prevention of vascular disease are uncertain because it reduces the risk of heart attack but increases the risk of internal bleeding, according to a study published in the May 30 issue of The Lancet.

FRIDAY, May 29 (HealthDay News) -- The benefits of using aspirin in the primary prevention of vascular disease are uncertain because it reduces the risk of heart attack but increases the risk of internal bleeding, according to a study published in the May 30 issue of The Lancet.

Colin Baigent, of the University of Oxford in the United Kingdom, and colleagues in the Antithrombotic Trialists' Collaboration conducted a meta-analysis of 22 trials that compared long-term aspirin use to control, six of which were primary prevention trials comprising 95,000 patients at low average risk and 16 of which were secondary prevention trials comprising 17,000 people at high average risk.

In the primary prevention trials, the risk of myocardial infarction was reduced by approximately one-fifth, but the risk of gastrointestinal and extracranial bleeds was increased, the investigators found. Aspirin yielded a 12 percent proportional reduction in serious vascular events (0.51 percent aspirin versus 0.57 percent control per year). In the secondary prevention trials, aspirin allocation resulted in a greater absolute reduction in serious vascular events (6.7 percent aspirin versus 8.2 percent control).

"In primary prevention without previous disease, aspirin is of uncertain net value as the reduction in occlusive events needs to be weighed against any increase in major bleeds. Further trials are in progress," the authors conclude.

Some members of the Antithrombotic Trialists' Collaboration reported financial ties to the pharmaceutical industry.

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