Summary of 3 large trials on daily aspirin therapy for primary prevention
| Trial | Population | Findings |
|---|---|---|
| ASCEND4 | 15,480 patients with diabetes and no prior CVD history | Therapy resulted in a 12% reduction in myocardial infarction and ischemic stroke Therapy resulted in a 30% increased risk for a major bleeding event, especially prominent in patients age 60 or older |
| ARRIVE5 | 12,546 patients with mean 17% 10-year CVD risk | No significant benefit in CVD prevention with therapy compared with placebo Twofold increase in gastrointestinal bleeding seen in aspirin therapy group |
| ASPREE6,7 | 19,114 patients, average age 74 | Therapy provided no benefit in preventing first nonfatal cardiovascular event or death Therapy showed a 30% increased risk of major nonfatal hemorrhage, particularly in upper-gastrointestinal bleeds and intracranial hemorrhage |
ARRIVE = Aspirin to Reduce Risk of Initial Vascular Events; ASCEND = A Study of Cardiovascular Events in Diabetes; ASPREE = Aspirin in Reducing Events in the Elderly; CVD = cardiovascular disease