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[Antiaggregation: aspirin]
A Eichenberger1, L Pontiggia, J H Beer
1Departement Innere Medizin, Kantonsspital Baden. adrian.eichenberger@ksb.ch
Therapeutische Umschau. Revue Therapeutique
|March 18, 2003
Summary
Aspirin effectively prevents secondary cardiovascular events, with a number needed to treat of 25. However, it carries risks of bleeding, necessitating careful consideration for primary prevention in high-risk individuals.
Area of Science:
- Cardiology
- Pharmacology
- Preventive Medicine
Background:
- Randomized trials confirm aspirin's efficacy as an antiplatelet agent.
- Aspirin is established for secondary prevention of cardiovascular events.
Purpose of the Study:
- To evaluate the benefits and risks of aspirin therapy.
- To define guidelines for aspirin use in primary and secondary prevention.
Main Methods:
- Review of randomized controlled trials on aspirin.
- Analysis of number needed to treat (NNT) and number needed to harm (NNH) data.
- Assessment of risk stratification models for primary prevention.
Main Results:
- NNT for vascular event prevention is approximately 25.
- NNH for cerebral bleeding is about 1,000; for severe extracerebral bleeding, 100-200.
- Primary prevention is recommended for high-risk patients (≥1-1.5% annual risk).
Conclusions:
- Aspirin is a valuable tool for secondary cardiovascular event prevention.
- Risk-benefit assessment is crucial, especially for primary prevention.
- Further discussion on mechanisms, interactions, and aspirin resistance is warranted.