Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Aspirin for Prevention of CV Events

JAMA; 2019 Jan 22; Zheng, Roddick

The use of aspirin in individuals without cardiovascular disease (CVD) was associated with a lower risk of CV events and an increased risk of major bleeding, a new study found. The systematic review and meta-analysis of included 13 trials with 164,225 participants without CVD (median age 62 years, 19% had diabetes). Researchers assessed the association of aspirin use for primary prevention with CV events and bleeding. The primary CV outcome was a composite of CV mortality, nonfatal myocardial infarction, and nonfatal stroke. The primary bleeding outcome was any major bleeding. Among the findings:

  • Participant median baseline risk of the primary CV outcome was 9.2%.
  • Aspirin use was associated with significant reductions in the composite CV outcome compared with no aspirin.
  • Aspirin use was also associated with an increased risk of major bleeding events compared with no aspirin.


Zheng SL, Roddick AJ. Association of aspirin use for primary prevention with cardiovascular events and bleeding events: A systematic review and meta-analysis. JAMA. 2019;321(3):277–287. doi:10.1001/jama.2018.20578.