Low-Dose Aspirin for Primary Prevention of Cardiovascular Events Comparing East Asians With Westerners: A Meta-Analysis

Authors

Rock Bum Kim
Ang Li
Ki-Soo Park
Yune-Sik Kang
Jang-Rak Kim
Eliano P Navarese
Diana A Gorog
Udaya S Tantry
Paul A Gurbel
Jin Yong Hwang
Oh-Young Kwon
Young-Hoon Jeong

Publication Date

12-1-2023

Journal

JACC: Asia

DOI

10.1016/j.jacasi.2023.07.008

PMID

38155798

PMCID

PMC10751647

PubMedCentral® Posted Date

9-12-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

aspirin, cardiovascular disease, East Asia, primary prevention

Abstract

BACKGROUND: East Asians have shown different risk profiles for both thrombophilia and bleeding than Western counterparts.

OBJECTIVES: The authors sought to evaluate the effect of low-dose aspirin for primary prevention between these populations.

METHODS: We searched randomized clinical trials (RCTs) for intervention with low-dose aspirin (≤100 mg once daily) in participants without symptomatic cardiovascular disease until December 31, 2021. The number of events between the arms was extracted for analysis. Pooled risk ratios (RRs) and risk differences (RDs) were analyzed in each population. Outcomes included a major adverse cardiovascular event (MACE), cardiovascular death, myocardial infarction, stroke, and major bleeding (intracranial hemorrhage and major gastrointestinal bleeding).

RESULTS: Two RCTs included 17,003 East Asians, and 9 RCTs had 117,467 Western participants. Aspirin treatment showed a similar effect in reducing the MACE rate (RR of East Asians: 0.87; 95% CI: 0.71-1.05; RR of Westerners: 0.90; 95% CI: 0.85-0.95) (

CONCLUSIONS: Low-dose aspirin for primary prevention in East Asians must be cautiously prescribed because of the increased risk of major bleeding relative to Western counterparts.

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