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… 

Figures and Tables from this paper

Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomised controlled trials
TLDR
A clear benefit of aspirin in the primary prevention of major cardiovascular events in people with diabetes remains unproved and sex may be an important effect modifier.
Review: aspirin was effective for primary prevention of stroke in women and MI in men but increased major bleeding
TLDR
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.
Aspirin for Primary Prevention of Cardiovascular Events: Meta-Analysis of Randomized Controlled Trials and Subgroup Analysis by Sex and Diabetes Status
TLDR
The use of low-dose aspirin was beneficial for primary prevention of CVD and the decision regarding an aspirin regimen should be made on an individual patient basis.
Aspirin for primary prevention of cardiovascular disease: a meta-analysis with a particular focus on subgroups
TLDR
Non-smokers, patients treated with statins, and males had the greatest risk reduction of MACE across subgroups, and aspirin use does not reduce all-cause or cardiovascular mortality and results in an insufficient benefit-risk ratio for CVD primary prevention.
Use of aspirin as primary prevention of cardiovascular events.
To the Editor: In their sex-specific meta-analysis of aspirin in the primary prevention of cardiovascular disease, Dr Berger and colleagues found results similar to the meta-analysis we performed as
Re-examining the cardiovascular therapeutic benefits of aspirin.
Although originally touted to have no effect on the heart, aspirin indeed exerts cardiovascular therapeutic benefits. Aspirin has been shown to reduce the risk of a first myocardial infarction (MI)
...
1
2
3
4
5
...

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
TLDR
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.
Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients
TLDR
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.
TLDR
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
TLDR
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
TLDR
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
TLDR
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
TLDR
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
Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men.
TLDR
The reduction associated with the use of aspirin in the risk of a first myocardial infarction appears to be directly related to the level of C-reactive protein, raising the possibility that antiinflammatory agents may have clinical benefits in preventing cardiovascular disease.
...
1
2
3
4
...