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Aspirin in Primary and Secondary Prevention in Elderly Adults Revisited

Ryan Wilson, MD, Jawahar Gazzala, MD, Jeff House, DO
Volume: 105 Issue: 2 February, 2012

Abstract:

Despite the frequency and long duration of aspirin use, its role in primary and secondary prevention in older adults is not well studied. This review takes a critical look at the available literature on aspirin efficacy in elderly adults, and some relevant guidelines for practicing physicians are suggested.

Article:

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References:

1. Patrono C, Rocca B. Aspirin, 110 years later. J Thromb Haemost 2009; 7 (suppl 1): 258–261.
 
2. Peto R, Gray R, Collins R, et al.. Randomized trial of prophylactic daily aspirin in British male doctors. BMJ 1988; 296: 313–316.
 
3. Steering Committee of the Physicians’ Health Study (PHS) Research Group. Final report on the aspirin component of the ongoing physicians’ health study. N Engl J Med 1989; 321: 129–135.
 
4. Thrombosis prevention trial: randomised trial of low-intensity oral anticoagulation with warfarin and low-dose aspirin in the primary prevention of ischaemic heart disease in men at increased risk. The Medical Research Council’s General Practice Research Framework. Lancet 1998; 351: 233–241.
 
5. Hansson L, Zanchetti A, Carruthers SG, et al.. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet 1998; 351: 1755–1762.
 
6. Sacco M, Pellegrini F, Roncaglioni MC, et al.. Collaborative Group. Primary prevention (PPP) of cardiovascular events with low-dose aspirin and vitamin E in type 2 diabetic patients: results of the Primary Prevention Project (PPP) trial. Diabetes Care 2003; 26: 3264–3272.
 
7. Murphy SA. Women’s Health Study (WHS): low dose aspirin in primary prevention. J Am Coll Cardiol 2005; 46: CS7–CS8.
 
8. Pulmonary Embolism Prevention (PEP) Trial Collaborative Group. Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet 2000; 355: 1295–1302.
 
9. Antiplatelets Trialists’ Collaboration, Baigent C, Blackwell L, Collins R, et al.. Collaborative overview of randomized trials of antiplatelets therapy: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ. 1994; 308: 81–106.
 
10. Bartolucci AA, Howard G. Meta-analysis of data from the six primary prevention trials of cardiovascular events using aspirin. Am J Cardiol 2006; 98: 746–750.
 
11. Berger JS, Roncaglioni MC, Avanzini F, et al.. Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials. JAMA 2006; 295: 306–313.
 
12. Wolff T, Miller T, Ko S. Aspirin for the primary prevention of cardiovascular events: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2009; 150: 405–410.
 
13. Nelson MR, Reid CM, Ames DA, et al.. Feasibility of conducting a primary prevention trial of low-dose aspirin for major adverse cardiovascular events in older people in Australia: results from the Aspirin in Reducing Events in the Elderly (ASPREE) pilot study. Med J Aust 2008; 189: 105–109.
 
14. 14. Smith D. Personal stroke risk (over the next 10 years). Available at: www.westernstroke.org/PersonalstrokeRisk1.xls. Accessed November 16, 2011.
 
15. Ogawa H, Nakayama M, et al.. Low-dose aspirin for primary prevention of atherosclerotic events in patients with type 2 diabetes: a randomized controlled trial (JPAD). JAMA 2008; 300: 2134–2141.
 
16. Belch J, MacCuish A, Campbell I, et al.. The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomized placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. BMJ 2008; 337: a1840.
 
17. Pignone M, Alberts MJ, et al.. Aspirin for Primary Prevention of Cardiovascular Events in People with Diabetes. A position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation. Diabetes Care 2010; 33: 1395–1402.
 
18. De Berardis G, Sacco M, Strippoli GF, et al.. Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomized controlled trials. BMJ 2009; 339.
 
19. Zhang C, Sun A, Zhang P, et al.. Aspirin for primary prevention of cardiovascular events in patients with diabetes: a meta-analysis. Diabetes Res Clin Pract 2010; 87: 211–218.
 
20. Bulpitt CJ. Secondary prevention of coronary heart disease in the elderly. Heart 2005; 91: 396–400.
 
21. Antiplatelets Trialists’ Collaboration. Collaborative overview of randomized trials of antiplatelets therapy: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ 1994; 308: 81–106.
 
22. Mahé I, Leizorovicz A, Caulin C, et al.. Aspirin for the prevention of cardiovascular events in the elderly. Drugs Aging 2003; 20: 999–1010.
 
23. Caplan LR, Kasner SE, Dashe JF. Clinical diagnosis of stroke subtypes. Up To Date. Last literature review version 18.2: May 2010. Topic Updated: June 2010. http://www.uptodate.com/contents/clinical-diagnosis-of-stroke-subtypes?source=search_result&search=clinical+diagnosis+of+stroke+subtypes&selectedTitle=1%7E150. Accessed December 23, 2011.
 
24. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Randomised trial of intravenous streptokinase, oral aspirin, both or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. Lancet 1988; II: 349–360.
 
25. Krumholz HM, Radford MJ, Ellerbeck EF, et al.. Aspirin for secondary prevention after acute myocardial infarction in the elderly: prescribed use and outcomes. Ann Intern Med 1996; 124: 292–298.
 
26. Maggioni AP, Maseri A, Fresco C, et al.. Age-related increase in mortality among patients with first myocardial infarctions treated with thrombolysis. The Investigators of the Gruppo Italiano per lo Studio della Sopravvivenza nell’lnfarto Miocardio (GISSI-2). N Engl J Med 1993; 329: 1442–1448.
 
27. Silagy CA, McNeill JJ, Donnan GA, et al.. The PACE pilot study: 12 month results and implications for future primary prevention trials in the elderly (prevention with low-dose aspirin of cardiovascular disease in the elderly). J Am Geriatr Soc 1994; 42: 643–647.
 
28. Nakashima S, Ota S, Arai S, et al.. Usefulness of anti-ulcer drugs for the prevention and treatment of peptic ulcers induced by low doses of aspirin. World J Gastroenterol 2009; 15: 727–731.
 
29. Sung JJ. Should we eradicate Helicobacter pylori in non-steroidal anti-inflammatory drug users? Aliment Pharmacol Ther 2009; 20 (suppl 2): 65–70.
 
30. Chan FK, Ching JY, Suen BY, et al.. Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen. N Engl J Med. 2001; 344: 967–973.
 
31. Lai KC, Lam SK, Chu KM, et al.. Lansoprazole for the prevention of recurrences of ulcer complications from long-term low-dose aspirin use. N Engl J Med 2002; 346: 2033–2038.

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