TY - JOUR T1 - Review: aspirin reduces vascular events but increases bleeding in primary and secondary prevention JF - Evidence Based Medicine JO - Evid Based Med SP - 172 LP - 172 DO - 10.1136/ebm.14.6.172 VL - 14 IS - 6 A2 - , Y1 - 2009/12/01 UR - http://ebm.bmj.com/content/14/6/172.abstract N2 - In primary and secondary prevention, what are the benefits and risks of aspirin? Included studies compared aspirin with no aspirin in primary or secondary prevention. Primary prevention trials had to include ⩾1000 patients who did not have diabetes and were scheduled for ⩾2 years of treatment. Secondary prevention trials included patients with previous myocardial infarction (MI), stroke, or transient cerebral ischaemia. Outcomes were serious vascular events (composite end point of non-fatal MI, stroke, or vascular death) and major extracranial bleeding. Individual patient data meta-analysis of 6 randomised controlled trials (RCTs) (n = 95 456) of primary prevention and 16 RCTs (n = 17 029) of secondary prevention. Meta-analysis of primary prevention RCTs showed that aspirin reduced serious vascular events and non-fatal MI but did not reduce stroke or vascular death, and increased major bleeding (table). In secondary prevention, aspirin led to a greater reduction of serious vascular events, MI, … ER -