Aspirin for stroke prevention in elderly patients with vascular risk factors

Interesting that aspirin as primary prevention did not show benefit. Your doctor should be able to point to the research that shows that aspirin is a benefit after your CVD event.
https://www.mdlinx.com/internal-medicine/medical-news-article/2016/05/25/aspirin-diabetes-mellitus-intracranial-hemorrhage-risk/6685421/?

Stroke

Uchiyama S, et al.

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The goal of this study was to assess the impact of aspirin on the risk of stroke and intracranial hemorrhage in the Japanese Primary Prevention Project (JPPP). Aspirin did not demonstrate any net benefit for the primary prevention of stroke in elderly Japanese patients with risk factors for stroke, whereas age >70 years, smoking, and diabetes mellitus were risk factors for stroke regardless of aspirin treatment.

Methods

• A total of 14 464 patients (age, 60-85 years) with hypertension, dyslipidemia, and diabetes mellitus participated and were randomized into 2 treatment groups: 100 mg of aspirin or no aspirin.
• The median follow-up period was 5.02 years.

Results

• The cumulative rate of fatal or nonfatal stroke was similar for the aspirin (2.068%; 95% confidence interval [CI], 1.750-2.443) and no aspirin (2.299%; 95% CI, 1.963-2.692) groups at 5 years; the estimated hazard ratio was 0.927 (95% CI, 0.741-1.160; P=0.509).
• Aspirin nonsignificantly reduced the risk of ischemic stroke or transient ischemic attack (hazard ratio, 0.783; 95% CI, 0.606-1.012; P=0.061) and nonsignificantly increased the risk of intracranial hemorrhage (hazard ratio, 1.463; 95% CI; 0.956-2.237; P=0.078).
• A Cox regression adjusted by the risk factors for all stroke, which were age >70 years, smoking, and diabetes mellitus, supported the above result.