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Safety of ceasing aspirin used without a clinical indication after age 70 years: a subgroup analysis of the ASPREE randomized trial

Nelson, MR ORCID: 0000-0001-9941-7161, Polekhina, G, Reid, CM, Tonkin, AM, Murray, AM, Kirpach, B, Ernst, ME, Lockery, JE, Shah, RC, Stocks, N, Orchard, SG and Zhou, Z ORCID: 0000-0002-0835-8686 2022 , 'Safety of ceasing aspirin used without a clinical indication after age 70 years: a subgroup analysis of the ASPREE randomized trial' , Annals of Internal Medicine , pp. 1-4 , doi: 10.7326/M21-3823.

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Background: The ASPREE (ASPirin in Reducing Events inthe Elderly) trial was a randomized, double-blind, placebocontrolledprimary prevention trial of aspirin in 19114 communitydwellingpersons aged 70 years and older (≥65 years in U.S.racial minorities). The results of the trial demonstrated that aspirinhad no benefit for disability-free survival, prevention of cardiovasculardisease events, or prevention of incident cancer,and increased risk for major bleeding and all-cause mortality(1–3). These findings were interpreted by some as being relevantonly to aspirin initiation and not aspirin discontinuation (4).The availability of evidence to inform the risks (for example, forgonecardiovascular protection) and benefits (for example,decreased risk for major hemorrhage) from aspirin cessationamong older adults is timely, given updated guideline recommendationsregarding aspirin use and clinical uncertainty (5). Objective: To investigate the effect of aspirin cessation versuscontinuation on disability-free survival and other clinical outcomesin a post hoc analysis of ASPREE participants who wereregularly taking aspirin before trial enrollment.

Item Type: Article
Authors/Creators:Nelson, MR and Polekhina, G and Reid, CM and Tonkin, AM and Murray, AM and Kirpach, B and Ernst, ME and Lockery, JE and Shah, RC and Stocks, N and Orchard, SG and Zhou, Z
Keywords: aspirin, cessation, safety, cardiovascular disease, bleeding, elderly
Journal or Publication Title: Annals of Internal Medicine
Publisher: Amer Coll Physicians
ISSN: 0003-4819
DOI / ID Number: 10.7326/M21-3823
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Copyright 2022 American College of Physicians

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