Aspirin With or Without Statin in Individuals Without Atherosclerotic Cardiovascular Disease Across Risk Categories
Pooled result · MIResult — go to the resultRelative risk 0.85 95% CI 0.77–0.95Authors' conclusion
In adults without ASCVD, concomitant statin appeared to significantly reduce absolute risk reduction for MI associated with aspirin without influencing bleeding risk. The anticipated absolute risk of major bleeding with aspirin exceeds absolute MI benefits for every level of ASCVD risk.
Study context
- Population
- Adults without atherosclerotic CVD (ASCVD); median age 64 years
- Participants
- 171,215 adults16 trials
- Comparison
- Aspirin vs control, stratified by statin use across ASCVD risk
- Outcome
- MI
Methodological detailsrandom-effects models
- Random-effects models
Pooled result
As reported in the abstract
Relative risk
0.85
95% CI 0.77–0.95
Aspirinvs Control
RR 0.85 (95% CI 0.77–0.95)
Further pooled results
Mortality
- Aspirin did not reduce mortality
Absolute myocardial infarction (MI) reduction with aspirin per 10,000 adults, by ASCVD risk and statin use · 5 years
- Very low risk, monotherapy
- 3 events
- Very low risk, with statin
- 1 event
- Very high risk, monotherapy
- 49 events
- Very high risk, with statin
- 37 events
- Absolute risk differences assume constant relative risks (RRs) across statin use and ASCVD risk
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| Major bleeding | 1.48 (1.32–1.66) | |
| 0.512Relative risk (log scale) |
Absolute major bleeding increase with aspirin per 10,000 adults, by ASCVD risk and statin use · 5 years
Events
- Very low risk, monotherapy
- 21
- Very low risk, with statin
- 20
- Very high risk, monotherapy
- 98
- Very high risk, with statin
- 94
Original publication
Aspirin With or Without Statin in Individuals Without Atherosclerotic Cardiovascular Disease Across Risk Categories. JACC Adv. Published 8 February 2023. doi:10.
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