Highlights
- •We studied the effect of aspirin on the prevention of cardiovascular diseases.
- •Its protective effects were regardless of age, sex, and underlying comorbidities.
- •The results were not significantly different from the recently changed guidelines of aspirin on primary prevention.
- •Nevertheless, periodic patient observation is required when using aspirin clinically, and it is necessary to prescribe it in consideration of advantages and disadvantages.
Abstract
Background and aims
Although the guidelines have been revised recently, the effect of aspirin for the
primary prevention of cardiovascular disease (CVD) is still controversial. Thus, we
aimed to evaluate the effect of aspirin on primary prevention in the real world.
Methods
Among the 4,266,268 participants without a history of CVD or previous prescription
of aspirin and other antiplatelet agents who were screened between 2002 and 2008,
268,963 persons who were prescribed low-dose aspirin (≤100 mg/day) over 90 days in
2002–2008 and 1,075,852 persons who did not receive aspirin were selected after propensity
score matching. A Cox proportional-hazards model was used to evaluate the effect of
low-dose aspirin on the development of CVD and bleeding episodes.
Results
Aspirin showed a protective effect on total CVD events (hazard ratio; 0.737, 95% confidence
interval; 0.729–0.745). The protective effect of aspirin on total CVD events was significant
in men, women and even in young participants (<65 years). Aspirin had a protective
effect in participants with diabetes or hypertension against all subcategories of
CVD. The HR of bleeding risk was 1.4–1.5 in aspirin group.
Conclusions
Low-dose aspirin generally showed a protective effect against CVD regardless of age,
sex, and underlying comorbidities in the real world. Though, the effect of aspirin
was evident at a young age, the risk of bleeding was also high (1.4–1.5 times), and
thus, careful prescription is required.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Accepted:
March 14,
2023
Received in revised form:
March 2,
2023
Received:
August 11,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier B.V.
