Evidence map›Paper›PMID 31280451›Full record

SynthesisHigh blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension2019

Aspirin Efficacy in Primary Prevention: A Meta-analysis of Randomized Controlled Trials.

Mahmoud Barbarawi, Babikir Kheiri, Yazan Zayed, Inderdeep Gakhal, Ahmad Al-Abdouh, Owais Barbarawi, Laith Rashdan, Fatima Rizk, Ghassan Bachuwa, Mohammad Luay Alkotob

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In one paragraph

Synthesis in High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Mechanisms of Immune Activation byFrontiers in neuroscience · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mahmoud BarbarawiDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, One Hurley Plaza, Flint, Michigan, 48503, USA. Mahmoud.albarbarawi@gmail.com.ORCID http://orcid.org/0000-0001-8218-2466
Babikir KheiriDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, One Hurley Plaza, Flint, Michigan, 48503, USA.
Yazan ZayedDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, One Hurley Plaza, Flint, Michigan, 48503, USA.
Inderdeep GakhalDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, One Hurley Plaza, Flint, Michigan, 48503, USA.
Ahmad Al-AbdouhDepartment of Internal Medicine, Saint Agnes Hospital, Baltimore, MD, USA.
Owais BarbarawiDepartment of Internal medicine, Mutah University, Al-Karak, Jordan.
Laith RashdanDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, One Hurley Plaza, Flint, Michigan, 48503, USA.
Fatima RizkCollege of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.
Ghassan BachuwaDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, One Hurley Plaza, Flint, Michigan, 48503, USA.
Mohammad Luay AlkotobDivision of Cardiology, Hurley Medical Center/Michigan State University, Flint, MI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe role of aspirin as a means of primary prevention remains controversial.

aimWe have conducted a meta-analysis of all randomized controlled trials (RCTs) to evaluate the role of aspirin in primary prevention.

methodsLiterature search was performed via PubMed, Embase, and the Cochrane Library for all related RCTs. All-cause mortality was the primary endpoint. Secondary endpoints included major adverse cardiovascular events (MACE), myocardial infarction (MI), cardiovascular mortality, cerebrovascular events, and bleeding events. We used a random effects model to report the risk ratios (RRs) with 95% confidence intervals (CIs).

resultsOur analysis included 17 RCTs (164,862 patients; 83,309 received aspirin and 81,744 received placebo). Our study did not demonstrate any significant reduction in all-cause mortality for patients treated with aspirin when compared with placebo (RR 0.97; 95% CI 0.93-1.01; P = 0.13). Sensitivity analysis performed by excluding healthy elderly (≥ 65) showed significant reductions in all-cause mortality in the aspirin-treated patients (RR 0.94; 95% CI 0.90-0.99; P = 0.01). There were no significant differences between both groups regarding cardiovascular mortality and cerebrovascular events (P > 0.05). However, aspirin-treated patients significantly reduced MACE and MI events (RR 0.89; 95% CI 0.85-0.93; P < 0.001 and RR 0.88; 95% CI 0.78-0.98; P = 0.02, respectively), respectively. However, aspirin was associated with a significantly higher incidence of bleeding, including major bleeding and intracranial bleeding (P < 0.001).

conclusionsAspirin use in primary prevention has resulted in a lower incidence of MACE and MI without significantly effecting cerebrovascular events. However, aspirin was associated with a higher bleeding risk. Use of aspirin as a means of primary prevention should be thoroughly discussed with patients and pursued based on the risk of cardiovascular disease while also considering bleeding risk.

Indexed as

AspirinCardiovascular AgentsCardiovascular DiseasesClinical Decision-MakingHemorrhageHumansIncidencePrimary PreventionProtective FactorsRandomized Controlled Trials as TopicRisk AssessmentRisk FactorsTreatment OutcomeAspirinCardiovascular AgentsAspirinCardiovascular diseaseMeta-analysisPrimary prevention

Identifiers

PMID31280451

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.