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Eur J Clin Invest. 2016 Feb;46(2):130-40. doi: 10.1111/eci.12575. Epub 2016 Jan 4.

A long-term risk-benefit analysis of low-dose aspirin in primary prevention.

Wu IC1,2, Hsieh HM3, Yu FJ1,2, Wu MC1, Wu TS1, Wu MT3,4,5.

Author information

1
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
2
Faculty of Medicine, Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
3
Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
4
Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
5
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract

BACKGROUND:

The long-term risk-benefit effect of occasional and regular use of low-dose aspirin (≤ 100 mg per day) in primary prevention of vascular diseases and cancers was calculated.

METHODS:

One representative database of 1 000 000 participants from Taiwan's National Health Insurance scheme in 1997-2000 was used. The potential study subjects were those aged 30-95 years, were found not to have been prescribed aspirin before 1 January 2000, but to have first been prescribed low-dose aspirin (≤ 100 mg per day) after that date and were followed up to 31 December 2009. Participants prescribed low-dose aspirin < 20% during the study period were considered occasional users and those prescribed ≥ 80% regular users. After the propensity score matching, rate differences of haemorrhage, ischaemia and cancer between these users were calculated their net clinical risk.

RESULTS:

A total of 1720 pairs were analysed. During the study period, haemorrhage and ischaemia occurred in 25 (1·45%) and 67 participants (3·90%) in occasional users and 69 (4·01%) and 100 participants (5·81%) in regular users, whereas cancer occurred in 32 participants (1·86%) in occasional users and 26 participants (1·51%) in regular users. The crude and adjusted net clinical risks of low-dose aspirin use between the two frequency of users (≥ 80% vs. < 20%) were 4·12% (95% CI = 2·19%, 6·07%; P < 0·001) and 3·93% (95% CI = 2·01%, 5·84%; P < 0·001).

CONCLUSIONS:

A long-term regular use of low-dose aspirin might not be better than occasional use in the primary prevention against major vascular diseases and cancer.

KEYWORDS:

cancer; haemorrhage; low-dose aspirin; primary prevention; risk-benefit analysis; vascular disease

PMID:
26640116
DOI:
10.1111/eci.12575
[Indexed for MEDLINE]

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