Trial reportHeart (British Cardiac Society)2015
Individualised prediction of alternate-day aspirin treatment effects on the combined risk of cancer, cardiovascular disease and gastrointestinal bleeding in healthy women.
Trial report in Heart (British Cardiac Society), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00000479 (Women's Health Study of Low-dose Aspirin and Vitamin E in Apparently Healthy Women), which is not on this map. Cited by 15 papers, 2 of them syntheses that pooled 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.
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.
Women's Health Study of Low-dose Aspirin and Vitamin E in Apparently Healthy Women
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Cardiovascular Protection of Aspirin in Chronic Kidney Disease Patients: An Updated Systematic Review and Meta-Analysis.Current vascular pharmacology · 2024Pooled it
- Aspirin and the Primary Prevention of Cardiovascular Diseases: An Approach Based on Individualized, Integrated Estimation of Risk.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2017Guideline
- The role of tumor-platelet interplay and micro tumor thrombi during hematogenous tumor metastasis.Cellular oncology (Dordrecht, Netherlands) · 2023Review
- Aspirin Use among Saudi Adults: The Prevalence and Users' Characteristics.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2022Article
- Article
- Summary of Updated Recommendations for Primary Prevention of Cardiovascular Disease in Women: JACC State-of-the-Art Review.Journal of the American College of Cardiology · 2020 · on this mapReview
- Role of aspirin in primary prevention of cardiovascular disease.Nature reviews. Cardiology · 2019Review
- Aspirin Use and Mortality in Two Contemporary US Cohorts.Epidemiology (Cambridge, Mass.) · 2018Article
- Sex differences in transplantation.Transplantation reviews (Orlando, Fla.) · 2017Review
- Aspirin Use in Women: Current Perspectives and Future Directions.Current atherosclerosis reports · 2016Review
- Primary Prevention of Atherosclerotic Cardiovascular Disease in Women.Current cardiovascular risk reports · 2016Article
- Aspirin, Ibuprofen, and the Risk of Colorectal Cancer in Lynch Syndrome.Journal of the National Cancer Institute · 2015Article
- Reducing Cardiovascular and Cancer Risk: How to Address Global Primary Prevention in Clinical Practice.Clinical cardiology · 2015Review
- How to walk the tightrope between harm and protection in selecting the optimal antiplatelet treatment strategy after transcatheter left atrial appendage occlusion.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2015Article
- Association between Aspirin Therapy and Clinical Outcomes in Patients with Non-Obstructive Coronary Artery Disease: A Cohort Study.PloS one · 2015Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundThe value of aspirin in primary prevention of cancer and cardiovascular disease (CVD) remains unclear. The aim of this study was to identify women who benefit from alternate-day aspirin with regard to all relevant outcomes, including cancer, CVD and major gastrointestinal bleeding.
methodsLong term follow-up data of 27 939 healthy women with baseline plasma samples in the Women's Health Study, a randomised trial of 100 mg alternate-day aspirin versus placebo, were used to develop competing risks models for individualised prediction of absolute risk reduction of the combination of CVD, cancer and major gastrointestinal bleeding by aspirin.
resultsAlthough aspirin was associated with a modestly decreased 15-year risk of colorectal cancer, CVD, and in some women non-colorectal cancer, aspirin treatment resulted in a negative treatment effect in the majority of women if gastrointestinal bleeding was also taken into account. The excess risk of major gastrointestinal bleeding by aspirin increased with age, but the benefits for colorectal cancer and CVD risk were also greater at higher age. Decision curves indicated that selective treatment of women ≥65 years may improve net benefit compared to treating all, none and prediction-based treatment. The observed 15-year number needed to treat to prevent one event among women ≥65 years was 29 (95% CI 12 to 102).
conclusionsConcurrent evaluation of the absolute effects on cancer, CVD and major gastrointestinal bleeding showed that alternate-day use of low-dose aspirin is ineffective or harmful in the majority of women in primary prevention. Selective treatment of women ≥65 years with aspirin may improve net benefit. TRIAL REGISTRATION NUMBER: NCT00000479.
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Registered trials
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 Socratic graph.