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Asociación del uso de aspirina para la prevención primaria con eventos cardiovasculares y eventos de sangrado: una revisión sistemática y un metanálisis

  • 0Faculty of Medicine, Imperial College London, London, United Kingdom.
Jama +

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23 de enero de 2019

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23 de enero de 2019

Ver abstracta en PubMed

Resumen

Este resumen es generado por máquina.

El uso de aspirina en la prevención primaria reduce los eventos cardiovasculares pero aumenta el riesgo de hemorragias importantes. Este meta-análisis informa las discusiones de los pacientes sobre la aspirina

Área De La Ciencia

  • Cardiología
  • La medicina preventiva
  • Ensayos clínicos

Sus Antecedentes

  • El papel de la aspirina en la prevención primaria cardiovascular se debate debido a los riesgos de sangrado.
  • Equilibrar los beneficios cardiovasculares contra los daños de la hemorragia es crucial para las estrategias preventivas.

Objetivo Del Estudio

  • Evaluar la asociación entre el uso de aspirina para la prevención cardiovascular primaria y la incidencia de eventos cardiovasculares y hemorragias mayores.
  • Para sintetizar la evidencia de grandes ensayos clínicos aleatorizados sobre el doble efecto de la aspirina en la prevención primaria.

Principales Métodos

  • Búsqueda sistemática de PubMed, Embase y Cochrane Library para ensayos clínicos aleatorizados relevantes (ECA) hasta noviembre de 2018.
  • La inclusión de 13 ECA con más de 164.000 participantes, centrados en individuos sin enfermedad cardiovascular preexistente.
  • Metaanálisis de los resultados cardiovasculares (mortalidad, infarto de miocardio, accidente cerebrovascular) y acontecimientos hemorrágicos importantes.

Principales Resultados

  • El uso de aspirina se asoció con una reducción significativa de los eventos cardiovasculares compuestos (RH, 0, 89; reducción del riesgo absoluto, 0, 38%).
  • El uso de aspirina aumentó significativamente el riesgo de acontecimientos hemorrágicos graves (HR, 1,43; aumento del riesgo absoluto, 0, 47%).
  • El número necesario para tratar el beneficio cardiovascular fue de 265; el número necesario para dañar el sangrado fue de 210.

Conclusiones

  • El uso de aspirina en la prevención primaria reduce el riesgo de eventos cardiovasculares pero aumenta el riesgo de hemorragias mayores.
  • Los hallazgos apoyan las discusiones individualizadas entre el paciente y el médico sobre los riesgos y beneficios de la aspirina para la prevención cardiovascular primaria.

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