Aspirin for the Primary Prevention of Cardiovascular Events: A Summary of the Evidence for the U.S. Preventive Services Task Force

View larger version (21K): [in a new window]   Figure 1. Meta-analysis of total coronary heart disease events. BMD = British Male Doctors' Trial; HOT = Hypertension Optimal Treatment Trial; OR = odds ratio; PHS = Physicians' Health Study; PPP = Primary Prevention Project; TPT = Thrombosis Prevention Trial. The result of the chi-square test for heterogeneity was 8.07 (P = 0.089).

View larger version (49K): [in a new window]   Figure 2. Meta-analysis of the effect of aspirin on coronary heart disease mortality (top), fatal and nonfatal stroke events (middle), and all-cause mortality (bottom). Results of the chi-square test for heterogeneity were 2.96 for coronary heart disease mortality, 5.36 for fatal and nonfatal stroke events, and 1.58 for all-cause mortality (P > 0.2 in all cases). BMD = British Male Doctors' Trial; HOT = Hypertension Optimal Treatment Trial; OR = odds ratio; PHS = Physicians' Health Study; PPP = Primary Prevention Project; TPT = Thrombosis Prevention Trial.

View larger version (36K): [in a new window]   Appendix (Figure 1). Analytic framework: aspirin to prevent cardiovascular events. CHD = coronary heart disease; CVD = cardiovascular disease; KQ = key question. KQ 1: Does aspirin chemoprevention in patients without known cardiovascular disease reduce the risk for myocardial infarction, stroke, and death? KQ 2: Does aspirin chemoprevention increase major gastrointestinal bleeding, hemorrhagic strokes, or both? KQ 3: What is the balance of benefits and harms for aspirin therapy in patients with different levels of cardiovascular risk?

View larger version (52K): [in a new window]   Appendix (Figure 2). Search strategy: beneficial effects. BMD = British Male Doctors' Trial; CVD = coronary vascular disease; ETDRS = Early Treatment Diabetic Retinopathy Study; HOT = Hypertension Optimal Treatment Trial; PHS = Physicians' Health Study; PPP = Primary Prevention Project; SAPAT = Swedish Angina Pectoris Aspirin Trial; TPT = Thrombosis Prevention Trial.

View larger version (54K): [in a new window]   Appendix (Figure 3). Search strategy: harmful effects.