Upper Gastrointestinal Bleeding in Patients Using Aspirin for Primary Prevention of Adverse Cardiovascular Events

In 2018, the ASPREE and ARRIVE trials showed that taking aspirin for primary prevention did not lower risk for adverse cardiovascular events but did impart bleeding risks (NEJM JW Gen Med Oct 15 2018 and N Engl J Med 2018; 379:1509; NEJM JW Gen Med Oct 1 2018 and Lancet 2018; 392:1036). Now, in this U.S. study, researchers examined whether upper gastrointestinal (UGI) bleeding associated with primary preventive aspirin decreased between 2016 and 2020, an interval that spans those 2018 reports. Using nationwide administrative data, 535,000 middle-aged and older patients (age, ≥45) who presented to an emergency department with UGI bleeding were identified.

Key findings were:

• From 2016 to 2020, the annual age- and sex-adjusted incidence rate of …