March 20, 2009 — New guidance on how aspirin should be used in both the primary and secondary prevention of coronary heart disease has come from three new reports published this week.
- CHARISMA trial
- 結論 ："Lower aspirin doses (75 to 81 mg/day) may optimize efficacy and safety for patients requiring aspirin for long-term prevention, especially those taking clopidogrel."
[ Clinical context] :
Aspirin can be useful in the prevention of cardiovascular events among both men and women. The current recommendations from the USPSTF summarize the best practice for using aspirin as primary prevention against cardiovascular disease.
[ pearls for practice] :
- Both MI and stroke are more common in men vs women, but women are more likely to have a fatal MI. Also, more women vs men die of stroke.
- The current recommendations from the USPSTF suggest that aspirin may be used to prevent MI in men and stroke in women, provided this benefit outweighs the risk for serious bleeding events. However, aspirin treatment is not recommended as primary prevention in women younger than 55 years and in men younger than 45 years.