We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Individualizing Aspirin Therapy for Prevention of Cardiovascular Events

Jean-Pierre Boissel, MD
JAMA. 1998;280(22):1949-1950. doi:10.1001/jama.280.22.1949.
Text Size: A A A
Published online


In this issue of THE JOURNAL, He and colleagues1 present the results of a meta-analysis on the risk of hemorrhagic stroke in patients treated with aspirin at the regimens currently prescribed for the prevention of carotid, coronary, or peripheral artery thrombotic occlusion. This review of a subset of 16 randomized controlled trials of aspirin for the prevention of cerebrovascular accidents, involving more than 55,000 patients, confirms that aspirin, even at the average dosage of 273 mg/d (range, 75-1500 mg/d), increases the risk of cerebral bleeding. Even though the main finding of this study is not new, important lessons can be drawn from this work. First, He et al1 provide a quantitative estimate of the excess risk due to aspirin instead of the vague notion that the risk is increased. This is another example of a useful application of the meta-analytic approach for evaluation of adverse events, ie, to assess the unbiased excess hazards over their natural occurrence when no single trial can sort out excess risk because the trial is sized for showing an efficacy.2 Furthermore, this estimate is obtained from the same patients as those in whom the benefit is measured, thus giving more relevance to the comparison of benefit and risk.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

21 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
[In Process Citation]. Gastroenterol Hepatol 2015;38 Suppl 1():56-63.
Vorapaxar in the secondary prevention of atherothrombosis. Expert Rev Cardiovasc Ther 2015;13(12):1293-305.