Effects of low-dose aspirin on primary prevention of cardiovascular events :a systematic review
10.3760/cma.j.issn.0253-3758.2010.04.010
- VernacularTitle:小剂量阿司匹林对心血管病一级预防效果及安全性的系统评价
- Author:
Hai-Qin TANG
1
;
Lin-Lin YANG
;
Shi-Lian HU
;
Gan SHEN
;
Ye-Huan SUN
;
Xiao-Hui HUANG
;
Jie-Hua LI
;
Ting-Juan XU
Author Information
1. 安徽医科大学附属第一医院
- Keywords:
Cardiovascular disease;
Aspirin;
Primary prevention;
Treatment outcome
- From:
Chinese Journal of Cardiology
2010;38(4):315-320
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect and safety of low-dose aspirin for primary prevention of cardiovascular events.Methods We searched for randomized controlled trials (RCT) in the following electronic databases:MEDLINE,EMbase,the Cochrane Library (Issue 3,2008),CBM,CNKI.Quality assessment and data extraction were conducted by two reviewers independently.All data were analyzed using Review Manager 4.2.Results Six studies (TPT,HOT,PPP,WHS,POPADAD,J-PAD) involving a total of 72 466 participants met the inclusion criteria.Meta-analysis results showed that:(1) Compared with placebo,the incidences of total cardiovascular events (RR = 0.85,95 % CI:0.80-0.92),stroke (RR = 0.87,95% CI:0.77-0.98),nonfatal stroke (RR = 0.81,95% CI:0.70-0.95) and transient ischemic attack (RR =0.76,95% CI:0.64-0.90) were significantly lower in low-dose aspirin group than those in placebo control group (all P＜0.05).(2) Nonfatal myocardial infarction (RR = 0.89,95 % CI:0.77 -1.02),death from cardiovascular causes (RR =0.98,95%CI:0.86-1.13) and death from any cause (RR =0.95,95%CI:0.88-1.02) were similar between the 2 groups (all P＞0.05).(3) The risk of coronary heart disease was reduced in low-dose aspirin group in the elderly (RR = 0.81,95% CI:0.70-0.94,P＜0.05).(4) The risk of bleeding was higher in low aspirin group compared to placebo group (RR = 1.15,95% CI:1.12-1.18,P＜0.O1).Conclusions low-dose aspirin use could reduce the incidences of total cardiovascular events,stroke,nonfatal stroke and transient ischemic attack but increase the risk of bleeding,the incidence of nonfatal myocardial infarction,death from cardiovascular causes and death from any cause was not affected by low-dose aspirin use.Low-dose aspirin use was also significantly reduced the risk of coronary heart disease in the elderly.
