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[Effects of low-dose aspirin on primary prevention of cardiovascular events: a systematic review]

Hai-qin Tang1, Lin-lin Yang, Shi-lian Hu

  • 1Department of Geriatrics, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China. tanghq898@sina.com.cn

Zhonghua Xin Xue Guan Bing Za Zhi
|July 27, 2010
PubMed

Insights

Low-dose aspirin significantly reduces cardiovascular events, stroke, and transient ischemic attacks. However, it increases bleeding risk and does not impact mortality or nonfatal myocardial infarction rates.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Pharmacology

Background:

  • Cardiovascular diseases remain a leading cause of mortality worldwide.
  • Primary prevention strategies aim to reduce the incidence of cardiovascular events.
  • Low-dose aspirin is widely studied for its potential prophylactic effects.

Purpose of the Study:

  • To systematically evaluate the efficacy and safety of low-dose aspirin for primary cardiovascular event prevention.
  • To synthesize evidence from randomized controlled trials (RCTs) on aspirin's impact on cardiovascular outcomes and bleeding risk.

Main Methods:

  • A comprehensive search of multiple electronic databases (MEDLINE, EMbase, Cochrane Library, CBM, CNKI) was performed.
  • Six relevant RCTs involving 72,466 participants were included after rigorous quality assessment and data extraction.
  • Meta-analysis was conducted using Review Manager 4.2 to pool the data.

Main Results:

  • Low-dose aspirin significantly reduced total cardiovascular events (RR=0.85), stroke (RR=0.87), nonfatal stroke (RR=0.81), and transient ischemic attack (RR=0.76) compared to placebo.
  • No significant differences were observed in nonfatal myocardial infarction, cardiovascular death, or all-cause death.
  • A notable reduction in coronary heart disease risk was observed in the elderly population (RR=0.81).
  • The risk of bleeding events was significantly higher in the low-dose aspirin group (RR=1.15).

Conclusions:

  • Low-dose aspirin is effective in reducing the incidence of certain cardiovascular events, including stroke and TIA.
  • Aspirin therapy is associated with an increased risk of bleeding.
  • The benefits of low-dose aspirin in reducing cardiovascular events must be weighed against the increased bleeding risk.
  • Low-dose aspirin demonstrated a significant benefit in reducing coronary heart disease risk specifically in the elderly population.
Abstract

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