Hemorrhagic Complications Associated With Aspirin

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July 23, 2012 By Steven Greer, MD

An article in the June, 2012, JAMA reported the findings of a large meta-analysis of the use of daily aspirin for primary prevention of myocardial infarctions and ischemic stroke. The authors concluded, “Despite important reductions in nonfatal MI, aspirin prophylaxis in people without prior CVD does not lead to reductions in either cardiovascular death or cancer mortality. Because the benefits are further offset by clinically important bleeding events, routine use of aspirin for primary prevention is not warranted and treatment decisions need to be considered on a case-by-case basis.”

We interviewed the author of the companion editorial, Dr. Jolanta Siller-Matula. She explains why the European cardiology guidelines now no longer recommend aspirin for primary prevention even though the American guidelines still do. She explains the “Number Needed to Treat” concept and why the risk-benefit ratio is not favorable for aspirin.