cqvip:BACKGROUND: Randomized trials have shown that lowdose aspirin decreases the ri sk of a first myocardial infarction in men, with little effect on the risk of is chemic stroke. There are few similar data in women. METHODS: We randomly assigne d 39,876 initially healthy women 45 years of age or older to receive 100 mg of a spirin on alternate days or placebo and then monitored them for 10 years for a f irst major cardiovascular event (i.e., nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes). RESULTS: During followup, 477 majo r cardiovascular events were confirmed in the aspirin group, as compared with 52 2 in the placebo group, for a nonsignificant reduction in risk with aspirin of 9 percent (relative risk, 0.91; 95 percent confidence interval, 0.80 to 1.03; P=0 .13). With regard to individual end points, there was a 17 percent reduction in the risk of stroke in the aspirin group, as compared with the placebo group (rel ative risk, 0.83; 95 percent confidence interval, 0.69 to 0.99; P=0.04), owing t o a 24 percent reduction in the risk of ischemic stroke (relative risk, 0.76; 95 percent confidence interval, 0.63 to 0.93; P=0.009) and a nonsignificant increa se in the risk of hemorrhagic stroke (relative risk, 1.24; 95 percent confidence interval, 0.82 to 1.87; P=0.31). As compared with placebo, aspirin had no signi ficant effect on the risk of fatal or nonfatal myocardial infarction (relative r isk, 1.02; 95 percent confidence interval, 0.84 to 1.25; P=0.83) or death from c ardiovascular causes (relative risk, 0.95; 95 percent confidence interval, 0.74 to 1.22; P=0.68). Gastrointestinal bleeding requiring transfusion was more frequ ent in the aspirin group than in the placebo group (relative risk, 1.40; 95 perc ent confidence interval, 1.07 to 1.83; P=0.02). Subgroup analyses showed that as pirin significantly reduced the risk of major cardiovascular events, ischemic st roke, and myocardial infarction among women 65 years of age or older. CONCLUSION S: In this large, primary-prevention trial among women, aspirin lowered the ris k of stroke without affecting the risk of myocardial infarction or death from ca rdiovascular causes, leading to a nonsignificant finding with respect to the pri mary end point.
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