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Inicio Medicina Clínica (English Edition) The role of aspirin as antiaggregant therapy in primary prevention. An update
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Vol. 153. Issue 8.
Pages 326-331 (October 2019)
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Vol. 153. Issue 8.
Pages 326-331 (October 2019)
Review
DOI: 10.1016/j.medcle.2019.05.005
The role of aspirin as antiaggregant therapy in primary prevention. An update
Papel de la Aspirina® como tratamiento antiagregante en prevención primaria. Puesta al día
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Nicolás Jiménez-Garcíaa,
Corresponding author
nijimenez93@gmail.com

Corresponding author.
, Javier de la Torre Limaa, Javier García Alegríaa,b
a Servicio de Medicina Interna, Agencia Sanitaria Costa del Sol, Marbella, Málaga, Spain
b Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain
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Tables (3)
Table 1. Methodology of the ASCEND, ARRIVE9,10 and ASPREE11–13 studies.
Table 2. Main results of the ASCEND, ARRIVE and ASPREE studies.
Table 3. Main results of the meta-analysis of trials on primary prevention of vascular events with Aspirin® by Zheng and Roddick.14
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Abstract

Aspirin indication in primary prevention has been questioned in the last ten years due to the publica-tion of several trials with neutral outcomes. In the last year, three research studies discussed in thisreview (ASCEND, ARRIVE, ASPREE) have weighed the benefit (cardiovascular events reduction) againstthe adverse effects (especially bleeding) in several situations such as general population with moderatecardiovascular risk, diabetics and elderly population. This review performs a detailed analysis of thesetrials and it also comments on a recent metanalysis that includes these projects along with others under-taken in the last 30 years. In addition, the current position of aspirin in primary prevention is establishedbased on the latest evidence reviewed.

Keywords:
Aspirin
Primary prevention
Antiaggregation
Cardiovascular events
Bleedings
Resumen

La indicación de la Aspirina®en prevención primaria ha sido puesta en duda en la última década a raízde la publicación de diversos ensayos con resultados neutros. En el último año, 3 trabajos comentados enesta revisión (ASCEND, ARRIVE y ASPREE) han ponderado el beneficio (reducción de eventos cardiovas-culares) frente a los eventos adversos (fundamentalmente hemorrágicos) en diversos escenarios comoson la población general con moderado riesgo cardiovascular, diabéticos y ancianos. La presente revisiónrealiza un análisis pormenorizado de estos 3 estudios y comenta un reciente metaanálisis que recogetanto estos trabajos como otros realizados durante los últimos 30 años. Además, se establece el actualposicionamiento de la Aspirina®en prevención primaria a la luz de la evidencia revisada.

Palabras clave:
Aspirina®
Prevención primaria
Antiagregación
Eventos cardiovasculares
Hemorragias

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