Cardiovascular Risk Reduction: Aspirin

Question 1

What are the benefits to daily aspirin?

Answer 1

1. moderate benefit to reduce risk of nonfatal MI (17% RR) and stroke (15% RR)
2. reduced colorectal cancer risk after taken for 5-10 yrs (40% RR)

Question 2

What are the potential harms of daily ASA?

Answer 2

GI bleed

hemorrhagic stroke

Question 3

Is the reduction of all-cause mortality significant for daily ASA?

Answer 3

No, but trends does trend that way

Question 4

In women, but nonfatal MI and stroke prevention benefit is about equal. How about for men?

Answer 4

More MI benefit than stroke benefit

Question 5

What is the recommendation grade for patients age 50-59?

Benefit of aspirin starts at what level of cardiovascular risk?

Answer 5

Grade B

10% (and only for those not at increased risk of bleeding with a life expectancy of at least 10 years)

Question 6

What is the recommendation grade for patients age 60-69

Answer 6

Grade C (selectively offer this service)

Question 7

What are some risk factors for bleeding on ASA?

Answer 7

older age
male sex
previous GI bleed/ulcer
current anticoagulation or NSAID use
uncontrolled HTN

Question 8

Do enteric coated formulations of aspirin reduce bleed risk?

Answer 8

nope

PPIs might though, but not clearly proven