Aspirin for Prevention: New Data Question Long-Term Benefits, Show Increased Risks
Berlin – Long-term use of low-dose aspirin (ASA) for primary prevention of cardiovascular events in healthy older adults may not deliver sustained benefits and is linked to notable bleeding risks and a potential rebound effect upon discontinuation, according to recent study data. The findings are prompting a re-evaluation of aspirin’s role in preventative care, particularly as alternative therapies emerge.
The research indicates that while aspirin could prevent 43 major adverse cardiovascular events (MACE) in the study population, this benefit was offset by a substantial increase in bleeding incidents – 100 new cases were observed among participants taking aspirin compared to placebo. Notably, researchers found a “rebound effect,” with cardiovascular event risk considerably increasing after stopping aspirin therapy. Within four years of ending treatment, 381 individuals from the aspirin group experienced a MACE, compared to 328 in the placebo group. This is potentially due to a surge in cyclooxygenase activity and platelet aggregation following discontinuation.
The study also revealed that the initially observed increase in mortality associated with preventative aspirin use normalized after the drug was stopped. Moreover, in secondary prevention – such as for patients post-infarction - aspirin is no longer considered the first-line treatment, with clopidogrel demonstrating superior efficacy, according to data referenced in the report.
