Table 3.
Meta-analyses reporting use of aspirin for the prevention of CV events: main features
| Meta-analysis | Publication year | Duration of follow-up (years) | Primary prevention studies included | Trial eligibility criteria | Aspirin doses included | Number of patients |
|---|---|---|---|---|---|---|
| Baigent et al. [5] | 1988–2005 | 3.6–10.1 | 6 (BDS, PHS, TPT, HOT, PPP, WHS) |
Includes randomized comparison of aspirin versus no aspirin Recruited ≥1,000 non-DM patients with ≥2 years of scheduled treatment |
75–500 mg; daily and alternate days | 95,000 |
| Bartolucci et al. [6] | 1988–2010 | 3.6–10.1 | 9 (WHS, BDS, PHS, HOT, PPP, TPT, AAAT, JPAD, POPADAD) | Not specified | 75–325 mg/dl | >100,000 |
| Berger et al. [30] | 1988–2010 | 3.7–10 | 9 (WHS, BDS, PHS, HOT, PPP, TPT, AAAT, JPAD, POPADAD) |
Randomized comparison of aspirin versus placebo or control Aspirin alone used for the primary prevention of CVD Data available on MI, stroke, and CV deaths |
75–500 mg; daily and alternate days | >100,000 |
| Raju et al. [7] | 1988–2010 | 3.6–10.1 | 9 (WHS, BDS, PHS, HOT, PPP, TPT, AAAT, JPAD, POPADAD) |
RCT Includes patients without a history of symptomatic CVD (>95 % of enrolled participants) Comparison of aspirin with placebo or no aspirin for prevention of CVD Reports at least one of the following outcomes: all-cause mortality, CV mortality, MI, stroke, and bleeding |
75–500 mg; daily and alternate days | >100,000 |
| Seshasai et al. [8] | 1988–2010 | 3.6–10.1 | 9 (WHS, BDS, PHS, HOT, PPP, TPT, AAAT, JPAD, POPADAD) |
Randomized placebo-controlled trials that had included ≥1,000 participants Primary prevention studies with ≥1 year of follow-up during which CHD and/or CVD outcomes (CHD, stroke, cerebrovascular disease, HF, and PAD) were recorded as the main endpoints, and details were provided of bleeding events |
75–500 mg; daily and alternate days | >100,000 |
| Butalia et al. [9] | 1989–2008 | 3.6–10.1 | 7 (PHS, ETDRS, HOT, PPP, WHS, POPADAD, JPAD) |
RCTs comparing aspirin versus cardiac-neutral comparator Included adults with DM without previous history or clinical evidence of CVD |
75–650 mg: daily and alternate days | 11,618 |
| De Berardis et al. [10] | 1989–2008 | 3.6–10.1 | 6 (PHS, ETDRS, PPP, WHS, POPADAD, JPAD) |
Prospective, RCTs Open or blinded trials of participants with DM who were allocated to aspirin treatment or a control group (placebo or no treatment) for the primary prevention of CV disease |
81–650 mg: daily and alternate days | 10,117 |
| Stavrakis et al. [11] | 1989–2008 | 3.6–10.1 | 5 (POPADAD, JPAD, PPP, HOT, WHS) |
Prospective, randomized, controlled, open or blinded trials Comparison of low-dose aspirin versus placebo or no treatment Inclusion of patients with no previous history of CVD, including MI, stroke, angina, TIA or symptomatic peripheral vascular disease (<10 % of patients with history of CVD allowed) Inclusion of patients with DM, either exclusively or as a subgroup Data on outcome measures of total and CV mortality, MI or stroke |
75–100 mg: daily and alternate days | 7,384 (with DM) |
| Younis et al. [12] | 1989–2008 | 3.7–10.1 | 6 (PHS, HOT, PPP, WHS, JPAD, POPADAD) | RCTs that assigned patients with DM to either aspirin as a primary prevention strategy or placebo/no aspirin | 75–325 mg; daily and alternate days | 7,374 |
| Zhang et al. [13] | 1989–2008 | 3.7–10.1 | 7 (PHS, ETDRS, HOT, PPP, WHS, POPADAD, JPAD) |
Prospective RCTs Participants with DM Assignment of participants to aspirin therapy or control group for primary prevention of CV events Follow-up duration at least 12 months Any of the data about major CV events (a composite of CV mortality, non-fatal MI or non-fatal stroke), MI, stroke, all-cause mortality, CV mortality or major bleeding |
75–325 mg; daily and alternate days | 11,618 |
AAAT Aspirin for Asymptomatic Atherosclerosis Trial, BDS British Doctors’ Study, CHD coronary heart disease, CV cardiovascular, CVD cardiovascular disease, DM diabetes mellitus, ETDRS Early Treatment Diabetic Retinopathy Study, HF heart failure, HOT Hypertension Optimal Treatment study, JPAD Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes trial, MI myocardial infarction, PAD peripheral arterial disease, PHS Physicians’ Health Study, POPADAD Prevention of Progression of Arterial Disease and Diabetes trial, PPP Primary Prevention Project, RCT randomized controlled trial, TIA transient ischemic attack, TPT Thrombosis Prevention Trial, WHS Women’s Health Study