The results of a new meta-analysis of the role of aspirin in primary prevention of cardiovascular diseases were recently published in the European Heart Journal. A total of 11 trials with 157 248 subjects were included. Among adults without established cardiovascular disease, aspirin was not associated with a reduction in the incidence of all-cause mortality; however, it was associated with an increased incidence of major bleeding. At a mean follow-up of 6.6 years, aspirin was not associated with a lower incidence of all-cause mortality [risk ratio (RR) 0.98, 95% confidence interval (CI) 0.93–1.02; P = 0.30]; however, aspirin was associated with an increased incidence of major bleeding (RR 1.47, 95% CI 1.31–1.65; P < 0.0001) and intracranial haemorrhage (RR 1.33, 95% CI 1.13–1.58; P = 0.001). A similar effect on all-cause mortality and major bleeding was demonstrated in diabetic and high cardiovascular risk patients.
European Heart Journal (2019) 40, 607–617. doi:10.1093/eurheartj/ehy813
