denotes an abstract that is clinically relevant.
denotes that this is a recommended PHD Trainee Session.
denotes that this is a ticketed session.Description:
In the past 10 years, there have been major changes in the available evidence related to aspirin for the prevention and treatment of both arterial and venous thrombosis. Although hematologists do not typically initiate or discontinue aspirin, they are often asked about risk-benefit trade-offs associated with various anti-thrombotic medications, including aspirin. Clinical questions about the net benefit of adding anti-platelet therapy are especially complex in patients who need to take an anticoagulant medication. This session will help the attendee to better estimate the risks and benefits of combination anti-thrombotic therapy for the prevention of arterial thrombosis. The session will also include an overview of the evidence pertinent to whether (and to what degree) aspirin can reduce the risk of venous thrombosis in various settings.
Dr. Michos will discuss the role of aspirin in primary prevention of atherosclerotic cardiovascular disease (ASCVD) in current era. In primary prevention, the absolute risks of vascular events are lower than in secondary prevention; however the complication rates (i.e. bleeding) are comparable. Recent evidence from randomized clinical trials have shown less benefit for prophylactic aspirin when used in combination with other contemporary ASCVD preventive therapies. The 2019 Primary Prevention Guideline from the American College of Cardiology (ACC) and American Heart Association (AHA) state most healthy people do not need to take aspirin (IIb indication). However, there may still be select patients aged 40 to 70 who have a very high risk of ASCVD who may benefit from aspirin if at low risk for bleeding; the role of aspirin for primary prevention in these patients will be reviewed in this talk. For example, one might still consider low dose aspirin (75 to 100 mg/day) among current smokers, those with a strong family history of premature ASCVD, those with very elevated cholesterol sub optimally treated with statins, those with subclinical atherosclerosis such as a coronary artery calcium scores >100, and select patients with diabetes at high ASCVD risk. However, these decisions are needed in the context of a clinician-patient risk discussion.
Dr. Barnes will discuss the role of combination aspirin and anticoagulation therapy in two key patient groups: those with dual indications (e.g., atrial fibrillation and coronary artery disease), and the emerging indication of atherosclerotic disease (stable coronary artery disease/peripheral artery disease and following peripheral artery disease revascularization). The talk will summarize key trial data and provide practical strategies to minimize bleeding risk with maximizing thrombotic risk reduction. Aspirin, a cornerstone therapy for arterial thrombotic disease, has historically been overlooked or considered ineffective for preventing thrombosis on the venous side of the circulatory system. In this lecture, Dr. Garcia will discuss the use of aspirin for both the primary and secondary prevention of deep vein thrombosis and pulmonary embolism. He will examine published evidence that informs questions about the relative safety and efficacy of aspirin when compared to placebo or to anticoagulant medications as a strategy to prevent venous thromboembolism.
Dr. Michos will discuss the role of aspirin in primary prevention of atherosclerotic cardiovascular disease (ASCVD) in current era. In primary prevention, the absolute risks of vascular events are lower than in secondary prevention; however the complication rates (i.e. bleeding) are comparable. Recent evidence from randomized clinical trials have shown less benefit for prophylactic aspirin when used in combination with other contemporary ASCVD preventive therapies. The 2019 Primary Prevention Guideline from the American College of Cardiology (ACC) and American Heart Association (AHA) state most healthy people do not need to take aspirin (IIb indication). However, there may still be select patients aged 40 to 70 who have a very high risk of ASCVD who may benefit from aspirin if at low risk for bleeding; the role of aspirin for primary prevention in these patients will be reviewed in this talk. For example, one might still consider low dose aspirin (75 to 100 mg/day) among current smokers, those with a strong family history of premature ASCVD, those with very elevated cholesterol sub optimally treated with statins, those with subclinical atherosclerosis such as a coronary artery calcium scores >100, and select patients with diabetes at high ASCVD risk. However, these decisions are needed in the context of a clinician-patient risk discussion.
Dr. Barnes will discuss the role of combination aspirin and anticoagulation therapy in two key patient groups: those with dual indications (e.g., atrial fibrillation and coronary artery disease), and the emerging indication of atherosclerotic disease (stable coronary artery disease/peripheral artery disease and following peripheral artery disease revascularization). The talk will summarize key trial data and provide practical strategies to minimize bleeding risk with maximizing thrombotic risk reduction. Aspirin, a cornerstone therapy for arterial thrombotic disease, has historically been overlooked or considered ineffective for preventing thrombosis on the venous side of the circulatory system. In this lecture, Dr. Garcia will discuss the use of aspirin for both the primary and secondary prevention of deep vein thrombosis and pulmonary embolism. He will examine published evidence that informs questions about the relative safety and efficacy of aspirin when compared to placebo or to anticoagulant medications as a strategy to prevent venous thromboembolism.