Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials.

@article{Berger2006AspirinFT,
  title={Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials.},
  author={Jeffrey S. Berger and Maria Carla Roncaglioni and F. Avanzini and Ierta Pangrazzi and Gianni Tognoni and David L. Brown},
  journal={JAMA},
  year={2006},
  volume={295 3},
  pages={
          306-13
        }
}
CONTEXT Aspirin therapy reduces the risk of cardiovascular disease in adults who are at increased risk. However, it is unclear if women derive the same benefit as men. OBJECTIVE To determine if the benefits and risks of aspirin treatment in the primary prevention of cardiovascular disease vary by sex. DATA SOURCES AND STUDY SELECTION MEDLINE and the Cochrane Central Register of Controlled Trials databases (1966 to March 2005), bibliographies of retrieved trials, and reports presented at… 

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References

SHOWING 1-10 OF 32 REFERENCES

Review: aspirin was effective for primary prevention of stroke in women and MI in men but increased major bleeding

RCTs that allocated participants to aspirin or a control group for primary prevention of CV disease and outcomes included CV mortality, myocardial infarction (MI), and stroke and quality of individual studies was assessed.

A Randomized Trial of Low-Dose Aspirin in the Primary Prevention of Cardiovascular Disease in Women

Subgroup analyses showed that aspirin significantly reduced the risk of major cardiovascular events, ischemic stroke, and myocardial infarction among women 65 years of age or older, leading to a nonsignificant finding with respect to the primary end point.

Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients

Aspirin (or another oral antiplatelet drug) is protective in most types of patient at increased risk of occlusive vascular events, including those with an acute myocardial infarction or ischaemic stroke, unstable or stable angina, previous myocardian infarctions, stroke or cerebral ischaemia, peripheral arterial disease, or atrial fibrillation.

An update on aspirin in the primary prevention of cardiovascular disease.

The current totality of evidence provides strong support for the initial finding that aspirin reduces the risk of a first MI, and the benefits of long-term aspirin therapy are likely to outweigh any risks.

Final report on the aspirin component of the ongoing Physicians' Health Study.

  • Medicine
    The New England journal of medicine
  • 1989
This trial of aspirin for the primary prevention of cardiovascular disease demonstrates a conclusive reduction in the risk of myocardial infarction, but the evidence concerning stroke and total cardiovascular deaths remains inconclusive because of the inadequate numbers of physicians with these end points.

Collaborative overview of randomised trials of antiplatelet therapy Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients

There was no appreciable evidence that either a higher aspirin dose or any other antiplatelet regimen was more effective than medium dose aspirin in preventing vascular events, so in each of the four main high risk categories overall mortality was significantly reduced.

Aspirin for the Primary Prevention of Cardiovascular Events: Recommendation and Rationale

The USPSTF concluded that the balance of benefits and harms is most favorable in patients at high risk for coronary heart disease (those with a 5-year risk 3%) but is also influenced by patient preferences, and some persons at lower risk may consider the potential benefits of aspirin to outweigh the potential harms.

Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women

In the wake of the reports of the Women’s Health Initiative and the Heart and Estrogen/Progestin Replacement Study, which unexpectedly showed that combination hormone therapy was associated with adverse CVD effects, there is a heightened need to critically review and document strategies to prevent CVD in women.

Randomised trial of prophylactic daily aspirin in British male doctors

A six year randomised trial was conducted among 5139 apparently healthy male doctors to see whether 500 mg aspirin daily would reduce the incidence of and mortality from stroke, myocardial