This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (68)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Neurology  • Stroke  • Venous Thromboembolism  • Alert me on articles by topic

Steven M. Weisman, PhD; David Y. Graham, MD

Arch Intern Med. 2002;162:2197-2202.

Background  In spite of the clear evidence of benefit of aspirin in the secondary prevention of cerebrovascular and cardiovascular thrombotic events, its use in patients at high risk due to a previous event remains suboptimal. A possible explanation for this underuse is concern regarding the relative benefit in relation to the potential risk for serious gastrointestinal events.

Objective  To compare the benefit and gastrointestinal risk of aspirin use for the secondary prevention of thromboembolic events.

Design  A meta-analysis was conducted using 6 trials (6300 patients) meeting the inclusion requirement of use of low-dose aspirin (325 mg/d) in approved secondary prevention indications.

Results  Aspirin reduced all-cause mortality by 18%. In addition, aspirin use reduced the number of strokes by 20%, myocardial infarctions by 30%, and other "vascular events" by 30%. Alternately, patients who took aspirin were 2.5 times more likely than those in the placebo group to have gastrointestinal tract bleeding. The number needed to treat for aspirin to prevent 1 death from any cause of mortality was 67, while 100 needed to be treated to detect 1 nonfatal gastrointestinal tract bleeding.

Conclusion  Aspirin use for the secondary prevention of thromboembolic events has a favorable benefit-to-risk profile and should be encouraged in those at high risk.

From Innovative Science Solutions, LLC, Morristown, NJ (Dr Weisman); and the Department of Medicine, Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Tex (Dr Graham).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Impact of allocation concealment on conclusions drawn from meta-analyses of randomized trials
Pildal et al.
Int J Epidemiol 2007;36:847-857.
ABSTRACT | FULL TEXT  

The Use of Aspirin for Primary Prevention of Colorectal Cancer: A Systematic Review Prepared for the U.S. Preventive Services Task Force
Dube et al.
ANN INTERN MED 2007;146:365-375.
ABSTRACT | FULL TEXT  

The Value Of Coronary Heart Disease Care For The Elderly: 1987-2002
Rosen et al.
Health Aff (Millwood) 2007;26:111-123.
ABSTRACT | FULL TEXT  

Effects of tomato extract on platelet function: a double-blinded crossover study in healthy humans.
O'Kennedy et al.
Am. J. Clin. Nutr. 2006;84:561-569.
ABSTRACT | FULL TEXT  

Sex Differences in Platelet Reactivity and Response to Low-Dose Aspirin Therapy
Becker et al.
JAMA 2006;295:1420-1427.
ABSTRACT | FULL TEXT  

The polypill: at what price would it become cost effective?
Franco et al.
J. Epidemiol. Community Health 2006;60:213-217.
ABSTRACT | FULL TEXT  

Long-Term Therapy to Prevent Stroke
Kirshner et al.
J Am Board Fam Med 2005;18:528-540.
ABSTRACT | FULL TEXT  

Effect Size Estimates of Lifestyle and Dietary Changes on All-Cause Mortality in Coronary Artery Disease Patients: A Systematic Review
Iestra et al.
Circulation 2005;112:924-934.
ABSTRACT | FULL TEXT  

Impact of Nonsteroidal Antiinflammatory Drugs on the Cardioprotective Effects of Aspirin
Corman et al.
The Annals of Pharmacotherapy 2005;39:1073-1079.
ABSTRACT | FULL TEXT  

What next for low dose aspirin?
Morgan
J. Epidemiol. Community Health 2005;59:3-4.
FULL TEXT  

Re: A Prospective Study of Aspirin Use and the Risk of Pancreatic Cancer in Women
Gensini et al.
JNCI J Natl Cancer Inst 2004;96:637-637.
FULL TEXT  

Inhibition of Clinical Benefits of Aspirin on First Myocardial Infarction by Nonsteroidal Antiinflammatory Drugs
Kurth et al.
Circulation 2003;108:1191-1195.
ABSTRACT | FULL TEXT  

OTHER ARTICLES NOTED (25 Oct 02 to 17 Jan 03)
Evid. Based Nurs. 2003;6:e1-7.
FULL TEXT