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Benefits and risks of aspirin in secondary and primary prevention of cardiovascular disease

Charles H Hennekens, MD, DrPH
Section Editors
Freek Verheugt, MD, FACC, FESC
Christopher P Cannon, MD
Deputy Editor
Gordon M Saperia, MD, FACC


Cardiovascular disease (CVD), which includes coronary heart disease, cerebrovascular disease, and peripheral artery disease, is far and away the leading the cause of death in the United States (US) and most developed countries and is rapidly becoming the leading cause of death in the world. In 2014, in the US alone, CVD caused more than 900,000 deaths. The totality of evidence from basic research, clinical investigations, observational epidemiologic studies, and randomized trials has provided strong support for the net benefits of aspirin in decreasing the risk of CVD events in a wide range of patients at sufficient risk [1]:

In acute ischemic syndromes such as acute myocardial infarction (MI) and unstable angina, and long term to reduce risks of recurrent MI, stroke, and vascular death.

In acute occlusive stroke and long term to reduce risks of MI, recurrent stroke, and vascular death

In secondary prevention of CVD after acute MI, occlusive stroke, transient ischemic attack, stable angina, and coronary artery bypass surgery to reduce risks of MI, stroke, and vascular death.

In primary prevention of a first MI as an individual clinical judgment for apparently healthy men and women at sufficient risk.


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Literature review current through: Sep 2016. | This topic last updated: Sep 27, 2016.
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