title: Aspirin underuse, non-compliance or cessation: definition, extent, impact and potential solutions in the primary and secondary prevention of cardiovascular disease.
abstract: Despite momentous breakthroughs in unraveling the pathophysiology of many chronic conditions and developing novel therapeutic agents, everyday clinical practice is still fraught with inadequate or inappropriate use of treatments with proven benefits. Aspirin is a paradigmatic example, as it is used for the primary and secondary prevention of cardiovascular disease and appears to have a beneficial impact on cancer risk. Yet, underuse, non-compliance or cessation of aspirin are not uncommon, may have an important clinical impact, and are not aggressively prevented or managed. Increasing the awareness of the extent and impact of aspirin underuse, non-compliance or cessation, and intensifying efforts at preventing them are worthy goals likely to yield significant benefits on cardiovascular morbidity and mortality worldwide, and possibly also on cancer outcomes.
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA. Electronic address: giuseppe.biondizoccai@uniroma1.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biondi-Zoccai
authors.affiliation: School of Public Health, Peking University, Beijing, PR China.
authors.forename: Yangfeng
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Atherosclerosis, Heart Institute of the University of São Paulo, São Paulo, Brazil.
authors.forename: Carlos V
authors.initials: CV
authors.lastname: Serrano
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Department of AngioCardioNeurology, IRCCS NeuroMed, Pozzilli, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Frati
authors.affiliation: Division of Cardiology, Utrecht University Medical Center, Utrecht, The Netherlands.
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Agostoni
authors.affiliation: VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Antonio
authors.initials: A
authors.lastname: Abbate
mesh_terms: D001241:Aspirin / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006801:Humans; D010349:Patient Compliance; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011322:Primary Prevention / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: Aspirin; Cardiovascular disease; Cessation; Compliance; Discontinuation; Underuse