{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:57:11Z","timestamp":1760057831101,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Aspirin is part of the therapeutic antithrombotic armamentarium for the management of patients with established clinically relevant atherosclerosis or thrombotic cardiovascular disease. Personalized medicine identifies those who benefit most or face fewer risks from aspirin. The role of aspirin in primary prevention is still debatable. We aimed to assess the risks and benefits of aspirin in this setting, using the data of the prospective VITAL (VITamins and Lifestyle) study. Methods: We conducted a retrospective evaluation of the VITAL cohort. In this analysis, participants were split according to aspirin usage. Aspirin use was evaluated regarding all-cause mortality, CV mortality, major cardiovascular event (MACE), myocardial infarction, coronary heart disease, total stroke, and hemorrhagic stroke. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated to explore the association between cardiovascular events and aspirin usage. The estimates were adjusted for demographic and clinical variables. Results: The aspirin users (n = 11,570) were older, more frequently men, the body mass index was higher, and the proportion of smokers was smaller compared with non-users (n = 13,927). After adjusting for demographic and clinical variables, aspirin was not identified as a predictor of cardiovascular death (HR 1.17, 95%CI 0.89 to 1.55), major cardiovascular events (HR 1.04, 95%CI 0.89 to 1.22), coronary heart disease (HR 1.16, 95%CI 0.98 to 1.37), nor stroke (HR 1.01, 95%CI 0.77 to 1.31). Conclusion: In this retrospective analysis of the VITAL cohort, aspirin was not associated with a reduced risk of cardiovascular mortality or events.<\/jats:p>","DOI":"10.3390\/jpm15030089","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T08:28:31Z","timestamp":1740558511000},"page":"89","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of Aspirin Use in Primary Prevention and Cardiovascular Events: A Retrospective Analysis of the VITAL Cohort"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2520-5673","authenticated-orcid":false,"given":"Daniel","family":"Caldeira","sequence":"first","affiliation":[{"name":"Centro Cardiovascular da Universidade de Lisboa\u2014CCUL@RISE, Centro Acad\u00e9mico de Medicina de Lisboa (CAML), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal"},{"name":"Cardiology Department, Hospital Universit\u00e1rio de Santa Maria\u2014ULS Santa Maria (ULSSM), 1649-035 Lisbon, Portugal"},{"name":"Centro de Estudos de Medicina Baseada na Evid\u00eancia (CEMBE), Faculdade de Medicina, Universidade de Lisboa, 1649-029 Lisbon, Portugal"},{"name":"Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, 1649-029 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1369-8423","authenticated-orcid":false,"given":"Mariana","family":"Alves","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, 1649-029 Lisbon, Portugal"},{"name":"Servi\u00e7o de Medicina, ULS Santa Maria (ULSSM), 1649-035 Lisboa, Portugal"}]},{"given":"Nilza","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, 1649-029 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5831-4921","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Costa","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, 1649-029 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3950-5113","authenticated-orcid":false,"given":"Joaquim J.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, 1649-029 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8034-4529","authenticated-orcid":false,"given":"Fausto J.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Centro Cardiovascular da Universidade de Lisboa\u2014CCUL@RISE, Centro Acad\u00e9mico de Medicina de Lisboa (CAML), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal"},{"name":"Cardiology Department, Hospital Universit\u00e1rio de Santa Maria\u2014ULS Santa Maria (ULSSM), 1649-035 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"ref_1","first-page":"CD004659","article-title":"Antiplatelet agents for preventing pre-eclampsia and its complications","volume":"2019","author":"Duley","year":"2019","journal-title":"Cochrane Database Syst. 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