Population: Adults at risk for ASCVD considering aspirin therapy.
Organizations
USPSTF 2022, FDA 2016, ACC/AHA 2019
Prevention Recommendation
–Use of low-dose aspirin (75–100 mg/d) for primary prevention is controversial.
Practice Pearls
• Aspirin for primary prevention does reduce the incidence of cardiovascular events, does not reduce mortality or nonfatal MI, and does increase bleeding risk. (Fam Prac. 2020;37(3):290-296)
• Risks of aspirin therapy: hemorrhagic stroke and GI bleeding (risk factors include age, male sex, GI ulcers, upper GI pain, concurrent NSAID/anticoagulant use, and uncontrolled hypertension).
• Establish risk factors using the ACC/AHA pooled cohort equation (PCE).
Sources
–USPSTF. JAMA. 2022:327(16):1577-1584.
–FDA. Use of Aspirin for Primary Prevention of Heart Attack and Stroke. 2016.
–J Am Coll Cardiol. 2019;74(10):e177-e232.