{"id":29565,"date":"2012-06-06T16:36:04","date_gmt":"2012-06-06T20:36:04","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=29565"},"modified":"2012-06-06T16:38:29","modified_gmt":"2012-06-06T20:38:29","slug":"real-world-bleeding-risk-with-aspirin-in-primary-prevention-examined","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/06\/06\/real-world-bleeding-risk-with-aspirin-in-primary-prevention-examined\/","title":{"rendered":"Real-World Bleeding Risk with Aspirin in Primary Prevention Examined"},"content":{"rendered":"<p><a href=\"http:\/\/jama.jamanetwork.com\/article.aspx?articleid=1172042\">A new study published in\u00a0<em>JAMA<\/em><\/a> provides substantial new evidence about the real-world effects of aspirin, including the risk for\u00a0 bleeding, in a broad \u00a0population. The study also sheds important new light on the effects of aspirin in a diabetic population.<\/p>\n<p>Giorgia De Berardis and colleagues analyzed data from more than 4 million people in Puglia, Italy and compared\u00a0186,425 people taking low-dose aspirin with the same number of matched controls not taking aspirin.<\/p>\n<p>Major bleeding events requiring hospitalization:<\/p>\n<ul>\n<li>aspirin: 5.58 (5.39-5.77) per 1000 person-years<\/li>\n<li>controls: 3.60 (3.48-3.72) per 1000 person-years<\/li>\n<li>Incidence rate ratio (IRR) 1.55 (1.48-1.63)<\/li>\n<\/ul>\n<p>Diabetics overall had an increased risk for major bleeding episodes, but this increased risk was not significantly associated with aspirin use:<\/p>\n<ul>\n<li>Hemorrhagic events in diabetics overall (compared with nondiabetics):\u00a0IRR 1.36 (1.28-1.44)<\/li>\n<li>Hemorrhagic events in diabetics taking aspirin compared with diabetics not taking aspirin: IRR 1.09 (0.97-1.22)<\/li>\n<\/ul>\n<p>The authors write that their findings demonstrate that bleeding events occur more frequently than had been observed in clinical trials. They calculate that for individuals with a 10-year risk for cardiovascular events between 10% and 20%, the risks and benefits of aspirin therapy are similar, causing two excess bleeds, and preventing two CV events, for every 1000 people treated each year.<\/p>\n<p>In <a href=\"http:\/\/jama.jamanetwork.com\/article.aspx?articleid=1172021\">an accompanying editorial<\/a>,\u00a0Jolanta Siller-Matula writes that the benefits of aspirin in <em>secondary<\/em> prevention are &#8220;not disputed,&#8221; since aspirin can prevent six major vascular events at the expense of one major bleeding event. But there is no such consensus for primary prevention, and Siller-Matula writes that the findings of the Italian study reinforce current European guidelines, which do not recommend aspirin for primary prevention.<\/p>\n<p>The <em>JAMA<\/em> study provides far more information about aspirin use in diabetics than had been previously\u00a0available.\u00a0Nevertheless, writes Siller-Matural, the decision whether to use aspirin for primary prevention in this population is still not clear, and will require additional data from ongoing studies.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A new study published in\u00a0JAMA provides substantial new evidence about the real-world effects of aspirin, including the risk for\u00a0 bleeding, in a broad \u00a0population. The study also sheds important new light on the effects of aspirin in a diabetic population. Giorgia De Berardis and colleagues analyzed data from more than 4 million people in Puglia, [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[364,311,665],"class_list":["post-29565","post","type-post","status-publish","format-standard","hentry","category-prevention","tag-aspirin","tag-bleeding","tag-primary-prevention"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/29565","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=29565"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/29565\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=29565"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=29565"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=29565"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}