Inappropriate use of aspirin for primary prevention

Abstract

Finer points Current guidelines vary slightly in their exact recommendations for aspirin use in the primary prevention setting. However, most consider aspirin appropriate for primary prevention when the 10-year CV risk is 6% or more. To determine the frequency of inappropriate use of aspirin in the primary prevention setting, researchers examined a cohort of patients receiving aspirin for primary prevention who were enrolled in the American College of Cardiology’s National Cardiovascular Disease Registry’s Practice Innovation and Clinical Excellence (PINNACLE) registry. Inappropriate aspirin use was characterized as use in patients with a 10-year CV risk of less than 6% by the Framingham CV risk assessment tool. A total of 68,808 patients were identi ed from 119 medical practices across the United States from January 2008 to June 2013. Of the 68,808 patients reviewed, 7,972 (11.6%) were classi ed as inappropriately receiving aspirin therapy for primary prevention. The mean 10-year CV risk in the inappropriate-use group was 4% compared with 24.5% in the appropriate-use group (P < 0.001). An assessment of individual practices revealed substantial variation for inappropriate aspirin use across practices, ranging from 0% to 71.8% (median 10.1%). However, only modest regional variations were observed in the northeast, midwest, south, and west.