People Centric Approach in secondary prevention of cardiovascular disease: the absolute benefits of aspirin on occlusive events are greater than the absolute harm of major bleeding. All must get it. Personal Centric Approach in primary prevention: the decision whether to use aspirin for primary prevention of cardiovascular disease and cancer be made based on shared decision-making, taking into account the probable benefits and harms of aspirin relative to the specific patient.
Three recent large randomized trials evaluating all-cause mortality associated with aspirin use indicate that the benefits and harms of aspirin for primary prevention are very closely balanced. In both, the ASCEND trial in patients with diabetes as well as the ARRIVE trial in patients with moderate CVD risk, the risk of all-cause death was similar with or without aspirin. In the ASPREE trial of individuals 70…
