Aspirin has been widely used in primary prevention of atherosclerotic cardiovascular disease(ASCVD)J141 Aspirin for primary prevention of ASCVD does not significantly reduce all-cause mortality or cardiovascular morta...Aspirin has been widely used in primary prevention of atherosclerotic cardiovascular disease(ASCVD)J141 Aspirin for primary prevention of ASCVD does not significantly reduce all-cause mortality or cardiovascular mortality,and the main benefit of aspirin for primary prevention of ASCVD is a significant reduction in non-fatal ischemic events including myocardial infarction,transient ischemic attack,ischemic stroke,and major cardiovascular events(cardiovascular death,non-fatal myocardial infarction,and non-fatal stroke),whereas the main risk is a significant increase in non-fatal major bleeding events including gastrointestinal bleeding and intracranial hemorrhage.1 Obviously,it makes sense to prescribe aspirin for primary prevention only if the benefits clearly outweigh the risks.In Europe and the United States,the benefit-risk ratio of aspirin for primary prevention has gradually decreased compared to the past due to the wide application of other primary prevention measures such as blood pressure reduction,smoking cessation,and the use of statins.Three recent large-scale clinical trials have shown that aspirin has no net clinical benefit when used in low-risk populations.19'1^Therefore,aspirin must be used with caution in the primary prevention of ASCVD.展开更多
文摘Aspirin has been widely used in primary prevention of atherosclerotic cardiovascular disease(ASCVD)J141 Aspirin for primary prevention of ASCVD does not significantly reduce all-cause mortality or cardiovascular mortality,and the main benefit of aspirin for primary prevention of ASCVD is a significant reduction in non-fatal ischemic events including myocardial infarction,transient ischemic attack,ischemic stroke,and major cardiovascular events(cardiovascular death,non-fatal myocardial infarction,and non-fatal stroke),whereas the main risk is a significant increase in non-fatal major bleeding events including gastrointestinal bleeding and intracranial hemorrhage.1 Obviously,it makes sense to prescribe aspirin for primary prevention only if the benefits clearly outweigh the risks.In Europe and the United States,the benefit-risk ratio of aspirin for primary prevention has gradually decreased compared to the past due to the wide application of other primary prevention measures such as blood pressure reduction,smoking cessation,and the use of statins.Three recent large-scale clinical trials have shown that aspirin has no net clinical benefit when used in low-risk populations.19'1^Therefore,aspirin must be used with caution in the primary prevention of ASCVD.
