Acetylsalicylic acid in primary and secondary prevention of cardiovascular diseases. Is it all obvious?

Abstract

The review tells about the results of clinical trials and meta-analyses demonstrating the effectiveness of acetylsalicylic acid (ASA) for secondary prevention of cardiovascular diseases, namely, improved prognosis for patients after myocardial infarction (MI), stroke or transient ischemic attack (TIA), people currently having AMI, stroke and stable CAD. Risk reduction is most significant for non-fatal events, and less significant for cardiovascular mortality. However, indications for use of ASA in patients without established cardiovascular disease remain a subject for debate today, as interpretation of the available data on ASA effect in primary prevention is quite complicated, while long-term administration is associated with a risk of hemorrhagic complications. Guidelines of the Working Group on Thrombosis of the European Society of Cardiology and the American Diabetes Association are presented, where the use of ASA for primary prevention is justified only in patients with high cardiovascular risk. Safety issues in the ASA treatment and options for prevention of gastrointestinal bleeding are also discussed.

Keywords

• ацетилсалициловая кислота
• первичная и вторичная профилактика сердечно-сосудистых заболеваний
• acetylsalicylic acid
• primary and secondary prevention of cardiovascular diseases