In ASCEND, 100-mg aspirin reduced the composite of MI, stroke, transient ischemic attack (TIA), or death from non-intracranial hemorrhage vascular causes by a relative 12% compared with placebo in adults with diabetes of any type (8.5% vs 9.6% at a mean of 7.4 years, P=0.01).
But major bleeding was increased by 29%, Jane Armitage, FRCP, FFPH, of the University of Oxford, England, and colleagues reported at the European Society of Cardiology meeting and simultaneously online in the New England Journal of Medicine.
The net effect was to prevent six vascular events and cause three major bleeds per 5,000 person-years in patients with under a 5% predicted 5-year risk, while those at a 10% or greater predicted risk had 11 vascular events prevented at the cost of 10 major bleeds per 5,000 person-years......."There was no group in which the benefits clearly outweighed the risks,"..............Again as expected, GI bleeding was more than twice as common on daily aspirin (0.97% vs 0.46%, P=0.0007), although overall serious adverse events and mortality were similar between arms..........."I think if you are well managed with diabetes, you've got your other risk factors under control, I think you need to consider very carefully whether or not for you the benefits of aspirin do outweigh the risks..........."You have intracranial bleeds and then everything else, because everything else is pretty treatable," he told MedPage Today. "I don't come away from that study saying you're trading one disease for another."
However, "you can manage heart attack," Nissen countered. "Keep in mind that a lot of these heart attacks are non-STEMIs, they're small, they're not hugely damaging, and people can die of gastrointestinal hemorrhage and have prolonged hospitalizations. It's not trivial.".............For now, the findings in ASCEND also undermined another rationale for primary prevention with aspirin -- protection against colorectal cancer.
The trial had "large numbers of cancers reported" and no suggestion that aspirin reduced the risk of cancer (11.6% vs 11.5%) or that any effect was beginning to emerge over time.........
So, the drug pushers killed about
as many as they saved? Or more? Millions have done this for many years, on medical advice. Was the cure worse than the disease? Or certainly no better? Help one thing, break another? I wonder how all of this would have worked against dietary and supplemental approaches? Would diet and exercise and maybe even supplements have worked at least as well? Better?
Post Edited (BillyBob@388) : 8/30/2018 8:13:05 AM (GMT-6)