000134996 001__ 134996
000134996 005__ 20240509150149.0
000134996 0247_ $$2doi$$a10.1016/j.ajpc.2024.100675
000134996 0248_ $$2sideral$$a138501
000134996 037__ $$aART-2024-138501
000134996 041__ $$aeng
000134996 100__ $$aSantilli, Francesca
000134996 245__ $$aNeeds-based considerations for the role of low-dose aspirin along the CV risk continuum
000134996 260__ $$c2024
000134996 5060_ $$aAccess copy available to the general public$$fUnrestricted
000134996 5203_ $$aCardiovascular disease (CVD) remains the leading cause of death worldwide. The risk of a cardiovascular (CV) event is not static and increases along a continuum, making identification and management complex. Aspirin has been the cornerstone of antiplatelet therapy in CV risk reduction and remains the only antiplatelet agent with current guideline recommendations throughout the CV risk continuum. In light of recent trials, the role of aspirin in CVD prevention in asymptomatic patients has been downgraded in clinical guidelines. However, a substantial proportion of asymptomatic patients have underlying conditions, such as advanced subclinical atherosclerosis that are associated with high CV risk. Advanced subclinical atherosclerosis has not been extensively investigated in patients in clinical trials but in the absence of significant bleeding risks, patients with subclinical atherosclerosis may particularly benefit from preventive aspirin therapy. Recent studies and clinical guidelines support the need for a personalized treatment approach for these patients, balancing their risk of future CV events against their relative bleeding risk. In this commentary, we first discussed various tools and strategies currently available for assessing CV and bleeding risks; we then provided two hypothetical cases to outline how these tools can be implemented for optimal management of patients with no prior CV events who, nonetheless, are susceptible to CVD. The first case details a young and apparently healthy patient with underlying advanced subclinical atherosclerosis; whereas the second case describes a patient with recently diagnosed type 2 diabetes mellitus who is at higher risk of CVD than their non-diabetic counterparts. For both cases, we considered patient clinical characteristics, CV and bleeding risks, as well as other risk factors to evaluate the appropriate treatment strategy and determine whether patients would obtain a net clinical benefit from low-dose aspirin therapy. These cases can serve as examples to guide clinical decision-making on the use of low-dose aspirin for primary CVD prevention and improve CVD management via a personalized approach.
000134996 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000134996 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000134996 700__ $$aAlbrecht, Gerhard
000134996 700__ $$aBlaha, Michael
000134996 700__ $$0(orcid)0000-0001-5932-2889$$aLanas, Ángel$$uUniversidad de Zaragoza
000134996 700__ $$aLi, Li
000134996 700__ $$aSibbing, Dirk
000134996 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000134996 773__ $$g18 (2024), 100675 [5 pp.]$$tAmerican journal of preventive cardiology$$x2666-6677
000134996 8564_ $$s492825$$uhttps://zaguan.unizar.es/record/134996/files/texto_completo.pdf$$yVersión publicada
000134996 8564_ $$s2108714$$uhttps://zaguan.unizar.es/record/134996/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000134996 909CO $$ooai:zaguan.unizar.es:134996$$particulos$$pdriver
000134996 951__ $$a2024-05-09-13:07:11
000134996 980__ $$aARTICLE