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Aspirin Efficacy in Primary Prevention

Poor old aspirin has again lost ground. Here’s an editorial from the January, 2019 issue of European Heart Journal describing a meta-analysis of aspirin’s lack of efficacy in subjects who have no cardiovascular disease risk factors:

Valgimigh M. The Remarkable Story of a Wonder Drug, Which Now Comes to an End in the Primary Prevention Setting: Say Bye-bye to Aspirin! Eur Heart J 2019;40:618–20.

The meta-analysis, available from the European Heart Journal site, is Mahmoud AN, Gad MM, Elgendyi Ay, et al. Efficacy and safety of aspirin for primary
prevention of cardiovascular events: a meta-analysis and trial sequential analysis of randomized controlled trials. Eur Heart J 2019: 40, 607–17

Participants, why do you think this new analysis contradicts the overwhelmingly positive results of the Physician Health Study and the Women’s Health Study of the 1980s and 1990s?

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