Trending Clinical Topics for September 2018

Ryan Syrek


September 28, 2018

Trending Clinical Topic of the Week (September 1-7): Aspirin

Two major trials presented at the European Society of Cardiology (ESC) Congress 2018 are largely responsible for the popularity of this week's top search term.  A Study of Cardiovascular Events in Diabetes (ASCEND)  included more than 15,000 middle-aged patients with diabetes but without evident heart disease. Results indicated that aspirin (100 mg daily) significantly reduced the risk for serious vascular events by 12% but raised the risk for major bleeding by 29%. However, the use of aspirin had no effect on overall mortality and did not increase fatal bleeding. The findings also revealed no effect on the rate of gastrointestinal cancer.

The Aspirin to Reduce Risk of Initial Vascular Events (ARRIVE) trial included 12,500 adults with presumed moderate risk for heart disease but without any evident heart disease. The results indicated that a daily dose of aspirin (100 mg) did not reduce the long-term risk for cardiovascular or cerebrovascular events or the risk for stroke. Although daily aspirin was associated with more gastrointestinal bleeding, such events were few (< 1%). As with the ASCEND trial, aspirin did not affect overall mortality or increase fatal bleeding incidents.

The results of these studies have combined to challenge the common practice of putting certain at-risk patients on daily aspirin. As experts reevaluate the role of this medication, they are emphasizing other strategies to reduce risks, such as weight loss, exercise, blood pressure management, and nicotine cessation.

For more information on cardiovascular prevention, read here.


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