Aspirin Was Not Beneficial in a Primary Prevention Trial

The effectiveness of aspirin for primary prevention of adverse cardiovascular (CV) events in contemporary patient populations remains unsettled. In the ARRIVE trial (funded by Bayer), 12,546 patients with no history of CV disease who were deemed to be at moderate risk were randomized to receive daily aspirin (100 mg) or placebo. Inclusion criteria were age 55 or older plus two to four risk factors for men, and age 60 or older plus three or more risk factors for women. Patients with diabetes or previous gastroduodenal ulceration or gastrointestinal bleeding were excluded. At baseline, 75% of participants were taking antihypertensive drugs, and 43% were taking statins.

During median follow-up of 5 years, the incidence of the primary endpoint (…