Aspirin does not prevent first vascular events

European Society of Cardiology Congress. No support for routine aspirin use. Patients quit beta-blockers.

Evidence for use of aspirin in secondary prevention is well established
Evidence for use of aspirin in secondary prevention is well established

Aspirin should not be routinely used for the primary prevention of vascular events, a UK study has found.

While evidence is well established for the use of aspirin for secondary prevention in patients with vascular disease, studies of aspirin for primary prevention have shown mixed results.

Researchers from the University of Edinburgh used ankle branchial index (ABI) to identify high-risk patients who did not have a history of cardiovascular disease.

The researchers randomly assigned 3,350 patients with asymptomatic atherosclerosis (defined by a low ABI), to receive either 100mg of aspirin or placebo.

Patients were then monitored for more than eight years for any vascular events.

Overall, 181 patients suffered a non-fatal coronary event or stroke in the aspirin group, compared with 176 in the placebo group.

All-cause mortality was found to be similar in both groups, but patients in the aspirin group were more likely to develop gastrointestinal ulcers.

Presenting the findings this week, lead researcher Professor Gerry Fowkes of the University of Edinburgh said that there was no support for routine use of aspirin for primary prevention of vascular events.

Professor Peter Weissberg, medical director at the British Heart Foundation, added: 'The findings of this study agree with our current advice that people who do not have symptomatic or diagnosed artery or heart disease should not take aspirin, because the risks of bleeding may outweigh the benefits.'

West London GP Dr Sarah Jarvis, a member of the British Cardiology Society, told GP that the latest findings could be the 'final nail in the coffin' for aspirin use in primary prevention of vascular events.

'Many GPs still prescribe aspirin for primary prevention despite the lack of evidence,' she said.

'Instead, we should now be thinking about educating our patients about the dangers of regular aspirin use.'

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