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J Am Coll Cardiol. 2014 Jul 22;64(3):319-27. doi: 10.1016/j.jacc.2014.03.049.

Aspirin therapy in primary cardiovascular disease prevention: a position paper of the European Society of Cardiology working group on thrombosis.

Author information

1
Department of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway.
2
Department of Cardiovascular Science, Catholic University, Rome, Italy.
3
Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands.
4
Medicina 3, Ospedale San Paolo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.
5
Department of Cardiovascular Disease, University of Bologna, Italy.
6
Consorzio Mario Negri, Sud Mozzagrogna Chieti, Italy.
7
Santo Andrés Hospital, Leiria, Portugal.
8
Department of Cardiology, Heartcenter, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
9
Institute of Cardiology, "G. D'Annunzio" University, Chieti, Italy. Electronic address: rdecater@unich.it.

Erratum in

  • J Am Coll Cardiol. 2014 Nov 4;64(18):1970.

Abstract

Although the use of oral anticoagulants (vitamin K antagonists) has been abandoned in primary cardiovascular prevention due to lack of a favorable benefit-to-risk ratio, the indications for aspirin use in this setting continue to be a source of major debate, with major international guidelines providing conflicting recommendations. Here, we review the evidence in favor and against aspirin therapy in primary prevention based on the evidence accumulated so far, including recent data linking aspirin with cancer protection. While awaiting the results of several ongoing studies, we argue for a pragmatic approach to using low-dose aspirin in primary cardiovascular prevention and suggest its use in patients at high cardiovascular risk, defined as ≥2 major cardiovascular events (death, myocardial infarction, or stroke) projected per 100 person-years, who are not at increased risk of bleeding.

KEYWORDS:

aspirin; bleeding; cancer; death; myocardial infarction; primary prevention

PMID:
25034070
DOI:
10.1016/j.jacc.2014.03.049
[Indexed for MEDLINE]
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