Effect of Aspirin on All-Cause Mortality in the Healthy Elderly

McNeil JJ, Nelson MR, Woods RL, et al. N Engl J Med. 2018 Sep 16. [Epub ahead of print] [CrossRef] [PubMed] 

Previous studies have suggested that daily aspirin may improve mortality from cardiovascular disease and cancer. The authors conducted the Aspirin in Reducing Events in the Elderly (ASPREE) trial which was a placebo-controlled trial of aspirin in older, healthy adults. Of the 19,114 persons who were enrolled, 9525 were assigned to receive aspirin and 9589 to receive placebo. The risk of death from any cause was 12.7 events per 1000 person-years in the aspirin group and 11.1 events per 1000 person-years in the placebo group (hazard ratio, 1.14; 95% confidence interval [CI], 1.01 to 1.29). Cancer was the major contributor to the higher mortality in the aspirin group, accounting for 1.6 excess deaths per 1000 person-years. In the context of previous studies, this result was unexpected and should be interpreted with caution.