Is it true? A baby Aspirin daily helps prevent vascular events (MI/Stroke) in all patients.

Bottom Line:

Aspirin decreases the incidence of coronary heart disease in adults who are at increased risk for heart disease. There is also good evidence that aspirin increases the incidence of gastrointestinal bleeding and fair evidence that aspirin increases the incidence of hemorrhagic strokes. There is no evidence of MI prevention with low dose aspirin in general population with no risk factors. Low-dose aspirin prevents stoke events in women >45 years of age.

Review

Patients at increased risk for cardiovascular (CV) events benefit from low-dose aspirin, provided that the patient does not have major risk factors for gastrointestinal (GI) or cerebral bleed.1 The risk of aspirin-induced bleeding usually outweighs the benefit of reducing cardiovascular events in patient with minimal to no risk factors for CV events.2,3, The results of Women’s Health Study (WHS) demonstrated that in women >45 years of age even with low risk factors for CV events, benefited from low-dose aspirin in reducing stroke events. No difference in cardiac event were note compared to placebo.4

References

1. Pearson TA, Blair SN, Daniels SR et al. AHA Guidelines for primary prevention of cardiovascular disease and stroke: 2002 update: consensus panel guide to comprehensive risk reduction for adult patients without coronary or other atherosclerotic vascular diseases. Circulation 2002; 106:388-91.
2. Nelson MR, Liew D et al. Epidemiologival modeling of routing use of low dose aspirin for the primary prevention of coronary heart disease and stoke in those aged >70. BMJ 2005 Jun 4;330(7503):1306
3. Taha AS, Angerson WJ, Knill-Jones RP et at. Upper gastrointestinal hemorrhage associated with low-dose aspirin and anti-thrombotic drugs – a 6-year analysis and comparison with non-steroidal anti-inflammatory drugs. Aliment Pharmacol Ther. 2005 Aug 15;22(4):285-9.
4. Ridker PM, Cook NR, Lee IM et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N.Eng J Med. 2005 Mar 31; 352:1293-304