[Acetylsalicylic acid in primary prevention of cardiovascular events; literature study].
OBJECTIVE
To evaluate literature data on the use of acetylsalicylic acid (ASA) as a primary prevention measure for cardiovascular events.


METHODS
Literature search.


METHODS
Using Medline, all randomised placebo-controlled trials of ASA published between 1985 and 1 May 2001, and which used cardiovascular morbidity and death as outcome measures were identified (search query: 'aspirin' and 'primary prevention'). Using the raw data presented in the source publication on death, fatal and non-fatal myocardial infarctions and cerebrovascular accidents (CVAs), all relative and absolute risk reductions were recalculated with confidence intervals.


RESULTS
In healthy middle-aged men, men with an increased cardiovascular risk profile and persons with diabetes mellitus or hypertension, the use of ASA reduces the incidence of myocardial infarction and has a neutral effect on cerebrovascular events. The protective effect of ASA seemed most marked in those persons with an increased risk of manifest atherosclerotic vascular disease.


CONCLUSIONS
Notwithstanding these findings, for each patient it remains essential to weigh up the cardiovascular risk profile against the small increased risk of complications when prescribing ASA.
Bredie
S J H
SJ
Afd. Algemeen Interne Geneeskunde, Universitair Medisch Centrum St Radboud, Postbus 9101, 6500 HB Nijmegen. s.bredie@aig.azn.nl
Wollersheim
H C H
HC
Verheugt
F W A
FW
Thien
Th
T
D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000188:drug therapy; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D003920:Diabetes Mellitus / Q000188:drug therapy; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control*; D009426:Netherlands / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011322:Primary Prevention / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D020521:Stroke / Q000517:prevention & control*
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin