Low-dose aspirin in the cardiovascular system

This chapter highlights practical aspects related to aspirin therapy in cardiovascular diseases, specifically, the benefits and hazards in different clinical settings. The absolute benefit of aspirin is linearly related to the risk of the patient. The benefit of aspirin can vary substantially in different settings. For example, in primary prevention in low-risk population, it is not unusual that the number of vascular events avoided equals the number of major bleeds induced by aspirin. In the secondary prevention, the benefits usually outweigh the excess of major bleeding complications. In this setting, the assessment of both bleeding risk and cardiovascular benefits of low-dose aspirin for any individual patient may be difficult in clinical practice. On the other hand, the relatively rare occurrence of major bleeding (gastrointestinal or cerebrovascular) complications should not be underestimated, mainly due to its high morbi-mortality. For all these reasons, in this chapter new developments in the field directed toward individualized risk assessment strategies are discussed.SCOPUS: ch.b