No more ppx ASA?

[winterallsummer]

According to Bloomberg, the FDA said in a statement that ingesting aspirin on a regular basis isn't recommended to people who have never experienced a cardiovascular event because the drug raises a person's risk of experiencing stomach and brain bleeds.

 

http://m.timesofindia.com/life-style/health-fitness/health/Stop-taking-aspirin-to-cut-heart-risk/articleshow/34784487.cms

 

Thoughts?

[True Anomaly]

No mention at all, either on that site or on the FDA's own site, of whether they're talking about 81 mg or 325 mg. The amount makes a difference in regards to increased bleeding risk.

[EMEDPA]

asa has other health benefits aside from decreasing risk for mi/cva. good evidence shows a lower risk for colon ca and melanoma as well.

[LKPAC]

very true.  I still recommend ASA 81mg daily for my patients over 50 if there are no contraindications.  Under 50 if risk factors.

[EMEDPA]

very true.  I still recommend ASA 81mg daily for my patients over 50 if there are no contraindications.  Under 50 if risk factors.

I take asa 81 mg every day with breakfast. multiple risk factors, bad family hx, etc.

[winterallsummer]

Bottom line is this. Is there new data to show a significant or morbidity causing bleeding risk exists that is greater than the protective benefit from either MI CVA or CA? I will have to look into it but not sure what data the FDA is citing here.

[GetMeOuttaThisMess]

Last time I saw the data it was a 50/50, "pick your poison" risk for CV "virgins".

[cbrsmurf]

High-risk, probably benefits:

http://www.thennt.com/nnt/aspirin-for-cardiovascular-prevention-after-prior-heart-attack-or-stroke/

 

http://www.ncbi.nlm.nih.gov/pubmed/11179262

 

Number needed to harm is about 1:200 for ASA.  Benefits for baby and full-dose ASA are about the same, but full/high-dose ASA has more adverse events.

 

There's no straight answer, different organizations disagree on the benefit of ASA for primary prevention.  One should really assess the CV risk of each patient.

 

 

Personally, I would try to put a pt on a statin for CV protection instead of ASA.  No bleed risk, multiple studies with consistent results/benefits, with a far less rate of serious side effects.

 

edit: + mediterranean diet, but how many people will do that :p

[ventana]

don't forget doing ASA once a week - 

 

remember ASA binds to the platelet and doesn't let go ever........ so to dose daily is really just for ease - BUT it does increase SE risks......

 

Weekly ASA - have recommended it a few times and with the rec to avoid for primary prevention might recommend more..