The authors, led by Professor Kausik Ray (St George’s University of London) conclude that the modest benefits and the significant increase in risk of bleeding do not justify routine use of aspirin in primary prevention, but that aspirin may be considered in certain higher-risk groups.
The recently published meta-analysis (Arch Intern Med 2012;172:209–16), included nine randomised placebo-controlled trials with a total of 100,000 participants. Results (table 1) showed that during a mean follow-up of six years, aspirin treatment reduced total cardiovascular events by 10%, driven primarily by a reduction in non-fatal myocardial infarction (M