A Systematic Review of Aspirin in Primary Prevention : Is It Time for a New Approach?
Brotons, Carlos (Institut d'Investigació Biomèdica Sant Pau)
Benamouzig, Robert (Avicenne Hospital (França))
Filipiak, Krzystof J. (Medical University of Warsaw)
Limmroth, Volker (University of Cologne)
Borghi, Claudio (University of Bologna)
Universitat Autònoma de Barcelona

Data:	2015
Resum:	Background and Objectives: While evidence in support of aspirin use in secondary prevention is well documented, the role of aspirin in primary prevention remains unclear. We conducted a systematic literature review to evaluate aspirin use in cardiovascular disease (CVD) and cancer primary prevention, and consider whether aspirin's role is set to become more clearly defined based on past and prospective studies. Data Sources: Utilizing PubMed, the reviewers identified appropriate Medical Subject Headings (MeSH) terms to establish CVD-based studies, cancer-based studies, and studies on adherence. Study Eligibility Criteria: Date restrictions of May 31, 2008 to May 31, 2013 were applied to capture the most robust meta-analyses and randomized controlled trials. Websites of relevant EU and US scientific societies were used to identify the key guidelines for aspirin use in primary prevention of CVD, and ClinicalTrials. gov was used to establish future or ongoing trials. Results: Evidence in support of aspirin prophylaxis is conflicting, though some meta-analyses have underlined potential benefit in reducing cardiovascular events. Despite this apparent benefit, bleeding risk with aspirin is consistently higher versus control, and remains a concern. A reduction of cancer incidence and mortality after a least 3 and 5 years treatment, respectively, is also apparent with aspirin. Conclusion: Available data on aspirin in primary prevention suggest a modest benefit for patients at high risk of CVD, and a promising benefit for those at risk of cancer. Future studies should help to elucidate whether the benefit of aspirin outweighs risk in appropriate patient groups.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	Aspirin ; Cardiovascular Diseases ; Humans ; Platelet Aggregation Inhibitors ; Primary Prevention ; Prospective Studies ; Randomized Controlled Trials as Topic ; Time Factors
Publicat a:	American Journal of Cardiovascular Drugs, Vol. 15 Núm. 2 (january 2015) , p. 113-133, ISSN 1179-187X

DOI: 10.1007/s40256-014-0100-5
PMID: 25502483

21 p, 417.7 KB

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