Aspirin for prevention of cardiovascular events

doi:10.1136/bmj.a1806

Published 16 October 2008, doi:10.1136/bmj.a1806
Cite this as: BMJ 2008;337:a1806

Editorials

Aspirin for prevention of cardiovascular events

Is only effective in established cardiovascular disease

The first 150 words of the full text of this article appear below.

In the linked randomised controlled trial (doi:10.1136/bmj.a1840),Belch and colleagues assess whether aspirin and antioxidants,given together or separately, reduce cardiovascular events inpatients with diabetes mellitus and asymptomatic peripheralarterial disease.¹

The use of aspirin for secondary prevention of cardiovascularevents in patients with coronary or cerebrovascular diseaseis well established and is based on extensive evidence fromthe Antithrombotic Trialists’ Collaboration.² That meta-analysisfound that aspirin was beneficial in patients with acute myocardialinfarction or ischaemic stroke; unstable or stable angina; andthose with previous myocardial infarction, stroke, or cerebralischaemia. However, not all patients with cardiovascular diseaserespond to aspirin, as shown by a recent meta-analysis of aspirintrials in peripheral artery disease.³

In contrast, studies evaluating the possible benefits of aspirinfor primary prevention in patients without cardiovascular diseasehave been consistently negative. A review by the United StatesFood and Drug Administration (FDA) . . . [Full text of this article]

William R Hiatt, professor of medicine

¹ University of Colorado Denver School of Medicine, Colorado Prevention Center, Denver, CO 80203, USA

Will.Hiatt@UCHSC.edu

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This article has been cited by other articles:

De Berardis, G., Sacco, M., Strippoli, G. F M, Pellegrini, F., Graziano, G., Tognoni, G., Nicolucci, A. (2009). Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomised controlled trials. BMJ 339: b4531-b4531 [Abstract] [Full text]
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