Aspirin for primary atherosclerotic cardiovascular disease prevention as baseline risk increases: A meta-regression analysis

Two problems with this:

1.  WHO reclassified stroke in 2006, now a neurological disease not cardiovascular disease?

2. We need to come up with an exact test that will identify those at bleeding risk instead of these blanket warnings. This worked but for the bleeding risk.

Aspirin for primary atherosclerotic cardiovascular disease prevention as baseline risk increases: A meta-regression analysis

Nudy M, Cooper J, Ghahramani M, et al

American Journal of Medicine|June 26, 2020

Whether aspirin is more efficacious for the primary prevention of atherosclerotic cardiovascular disease (ASCVD) as the baseline risk rises, was investigated via this meta-regression analysis. Researchers analyzed randomized controlled trials (RCTs) comparing aspirin with control for primary prevention as well as assessed ASCVD (composite of myocardial infarction and ischemic stroke) and major bleeding. Overall 12 RCTs with 963,829 patient-years of follow-up were found. Findings revealed that a decrease in ASCVD was achieved by using aspirin for primary prevention(So success?); however, its clinical significance is unlikely in view of the increase in bleeding. No increase in the treatment effect of aspirin was evident as ASCVD risk increased, as many hypothesize(You just contradicted your statement above). There is no hint from these findings that use of aspirin for higher-risk primary prevention patients is beneficial.

Read the full article on American Journal of Medicine.