The case against routine aspirin use for primary prevention in low-risk adults.

摘要

Given the burden of cardiovascular disease (CVD) in Western society, preventing the life-threatening complications of acute arterial thrombosis is paramount. Platelets play a central role in arterial thrombosis. The antiplatelet agent aspirin alters platelet function by inhibiting cyclooxygenase-1 enzymes. This prevents the generation of thromboxane A_2, an important amplifier of platelet activation. Numerous clinical trials have established the effectiveness of aspirin use for acute coronary syndromes and for secondary prevention of CVD, as well as after percutaneous coronary interventions. The major benefit of aspirin appears to be a reduction in recurrent cardiovascular events. However, this reduction in events comes with the risk of increased bleeding, including gastrointestinal and intracerebral hemorrhage.