In this meta-analysis of 95,000 subjects from 6 trials, ASA for primary prevention in low risk patients was associated with a small reduction in serious vascular events and coronary events (ARR of coronary events was 0.06% per year), but a higher risk of hemorrhagic stroke (absolute increase 0.01% per year) and higher risk of GI / extra-cranial bleeding (absolute increase 0.03% per year). There does not appear to be an overall advantage of ASA in low risk patients (abstract).
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