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Whitlock EP, Williams SB, Burda BU, et al. Aspirin Use in Adults: Cancer, All-Cause Mortality, and Harms: A Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Sep. (Evidence Syntheses, No. 132.)
Aspirin Use in Adults: Cancer, All-Cause Mortality, and Harms: A Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet].
Show detailsTable 10Absolute Risk Reduction and Number Needed to Treat or Harm With ASA, CVD Primary Prevention Trials
| Included ASA Doses | Outcome | Risk Level‡ | Baseline Risk of Outcome, Events per 10,000 p-y | Baseline Risk of Outcome, Events per 1,000 p-y | Events prevented per 10,000 p-y (95% CI) | Events prevented per 1,000 p-y (95% CI) | NNT-B per Year (95% CI)† | NNT-H per Year (95% CI)† |
|---|---|---|---|---|---|---|---|---|
| All ASA doses | All-cause mortality* | Low | 31.9 | 3.19 | 1.9 (0.3 to 3.8) | 0.19 (0.03 to 0.38) | 5,263 (2,632 to 33,333) | -- |
| Med | 95.5 | 9.55 | 5.7 (1.0 to 11.5) | 0.57 (0.10 to 1.15) | 1,754 (870 to 10,000) | -- | ||
| High | 135.4 | 13.54 | 8.1 (1.4 to 16.3) | 0.81 (0.14 to 1.63) | 1,235 (613 to 7,143) | -- | ||
| Fatal CVD (fatal MI/coronary, fatal stroke, and CVD mortality)* | Low | 6.3 | 0.63 | 0.4 (-0.2 to 0.9) | 0.04 (-0.02 to 0.09) | -- | -- | |
| Med | 38.0 | 3.80 | 2.3 (-1.1 to 5.7) | 0.23 (-0.11 to 0.57) | -- | -- | ||
| High | 46.2 | 4.62 | 2.8 (-1.4 to 6.9) | 0.28 (-0.14 to 0.69) | -- | -- | ||
| Nonfatal stroke* | Low | 12.1 | 1.21 | 0.7 (-0.7 to 1.9) | 0.07 (-0.07 to 0.19) | -- | -- | |
| Med | 27.7 | 2.77 | 1.7 (-1.7 to 4.4) | 0.17 (-0.17 to 0.44) | -- | -- | ||
| High | 48.4 | 4.84 | 2.9 (-2.9 to 7.7) | 0.29 (-0.29 to 0.77) | -- | -- | ||
| Nonfatal MI/coronary* | Low | 9.0 | 0.90 | 1.8 (1.1 to 2.5) | 0.18 (0.11 to 0.25) | 5,556 (4,000 to 9,091) | -- | |
| Med | 29.3 | 2.93 | 5.9 (3.5 to 8.2) | 0.59 (0.35 to 0.82) | 1,695 (1,220 to 2,857) | -- | ||
| High | 84.4 | 8.44 | 16.9 (10.1 to 23.6) | 1.69 (1.01 to 2.36) | 592 (424 to 990) | -- | ||
| Major CVD events* | Low | 25.9 | 2.59 | 2.9 (1.3 to 4.1) | 0.29 (0.13 to 0.41) | 3,448 (2,439 to 7,692) | -- | |
| Med | 90.8 | 9.08 | 10.0 (4.5 to 14.5) | 1.00 (0.45 to 1.45) | 1,000 (690 to 2,222) | -- | ||
| High | 159.5 | 15.95 | 17.5 (8.0 to 25.5) | 1.75 (0.80 to 2.55) | 571 (392 to 1,250) | -- | ||
| Cancer incidence | Low | 56.5 | 5.65 | 1.1 (-2.3 to 4.0) | 0.11 (-0.23 to 0.40) | -- | -- | |
| Med | 98.1 | 9.81 | 2.0 (-3.9 to 6.9) | 0.20 (-0.39 to 0.69) | -- | -- | ||
| High | 141.2 | 14.12 | 2.8 (-5.6 to 9.9) | 0.28 (-0.56 to 0.99) | -- | -- | ||
| Cancer mortality | Low | 12.3 | 1.23 | 0.5 (-0.7 to 1.6) | 0.05 (-0.07 to 0.16) | -- | -- | |
| Median | 34.8 | 3.48 | 1.4 (-2.1 to 4.5) | 0.14 (-0.21 to 0.45) | -- | -- | ||
| High | 72.5 | 7.25 | 2.9 (-4.4 to 9.4) | 0.29 (-0.44 to 0.94) | -- | -- | ||
| Major GI bleeding | Low | 2.3 | 0.23 | -1.4 (-2.1 to -0.7) | -0.14 (-0.21 to -0.07) | -- | 7,143 (4,762 to 14,286) | |
| Median | 4.9 | 0.49 | -2.9 (-4.4 to -1.6) | -0.29 (-0.44 to -0.16) | -- | 3,448 (2,273 to 6,250) | ||
| High | 10.4 | 1.04 | -6.1 (-9.4 to -3.3) | -0.61 (-0.94 to -0.33) | -- | 1,639 (1,064 to 3,030) | ||
| High‡ | 14.0‡ | 1.40‡ | -8.3 (-12.7 to -4.5) | -0.83 (-1.27 to -0.45) | -- | 1,205 (787 to 2,222) | ||
| High‡ | 20.0‡ | 2.00‡ | -11.8 (-18.2 to -6.4) | -1.18 (-1.82 to -0.64) | -- | 847 (549 to 1,563) | ||
| ICH including hemorrhagic stroke | Low | 2.0 | 0.20 | -0.6 (-1.3 to 0.0) | -0.06 (-0.13 to 0.00) | -- | -- | |
| Med | 4.2 | 0.42 | -1.1 (-2.8 to 0.1) | -0.11 (-0.28 to 0.01) | -- | -- | ||
| High | 12.5 | 1.25 | -3.4 (-8.3 to 0.3) | -0.34 (-0.83 to 0.03) | -- | -- | ||
| High‡ | 17.0‡ | 1.70‡ | -4.6 (-11.2 to 0.3) | -0.46 (-1.12 to 0.03) | -- | -- | ||
| ASA dose ≤ 100 mg per day | All-cause mortality* | Low | 31.9 | 3.19 | 1.9 (-0.3 to 3.8) | 0.19 (-0.03 to 0.38) | -- | -- |
| Med | 95.5 | 9.55 | 5.7 (-1.0 to 11.5) | 0.57 (-0.10 to 1.15) | -- | -- | ||
| High | 135.4 | 13.54 | 8.1 (-1.4 to 16.3) | 0.81 (-0.14 to 1.63) | -- | -- | ||
| Fatal CVD (fatal MI/coronary, fatal stroke, and CVD mortality)** | Low | 6.3 | 0.63 | 0.3 (-0.7 to 1.0) | 0.03 (-0.07 to 0.10) | -- | -- | |
| Med | 38.0 | 3.80 | 1.5 (-4.2 to 6.1) | 0.15 (-0.42 to 0.61) | -- | -- | ||
| High | 46.2 | 4.62 | 1.8 (-5.1 to 7.4) | 0.18 (-0.51 to 0.74) | -- | -- | ||
| Nonfatal stroke* | Low | 12.1 | 1.21 | 2.2 (0.6 to 3.5) | 0.22 (0.06 to 0.35) | 4,545 (2,857 to 16,667) | -- | |
| Med | 27.7 | 2.77 | 5.0 (1.4 to 8.0) | 0.50 (0.14 to 0.80) | 2,000 (1,250 to 7,143) | -- | ||
| High | 48.4 | 4.84 | 8.7 (2.4 to 14.0) | 0.87 (0.24 to 1.40) | 1,149 (714 to 4,167) | -- | ||
| Nonfatal MI/coronary* | Low | 9.0 | 0.90 | 1.3 (0.3 to 2.2) | 0.13 (0.03 to 0.22) | 7,692 (4,545 to 33,333) | -- | |
| Med | 29.3 | 2.93 | 4.4 (0.9 to 7.3) | 0.44 (0.09 to 0.73) | 2,273 (1,370 to 11,111) | -- | ||
| High | 84.4 | 8.44 | 12.7 (2.5 to 21.1) | 1.27 (0.25 to 2.11) | 787 (474 to 4,000) | -- | ||
| Major CVD events* | Low | 25.9 | 2.59 | 3.1 (1.3 to 4.7) | 0.31 (0.13 to 0.47) | 3,226 (2,128 to 7,692) | -- | |
| Med | 90.8 | 9.08 | 10.9 (4.5 to 16.3) | 1.09 (0.45 to 1.63) | 917 (613 to 2,222) | -- | ||
| High | 159.5 | 15.95 | 19.1 (8.0 to 28.7) | 1.91 (0.80 to 2.87) | 524 (348 to 1,250) | -- | ||
| Cancer incidence | Low | 56.5 | 5.65 | 1.1 (-2.3 to 4.5) | 0.11 (-0.23 to 0.45) | -- | -- | |
| Med | 98.1 | 9.81 | 2.0 (-3.9 to 7.8) | 0.20 (-0.39 to 0.78) | -- | -- | ||
| High | 141.2 | 14.12 | 2.8 (-5.6 to 11.3) | 0.28 (-0.56 to 1.13) | -- | -- | ||
| Cancer mortality | Low | 12.3 | 1.23 | 0.6 (-0.7 to 1.8) | 0.06 (-0.07 to 0.18) | -- | -- | |
| Med | 34.8 | 3.48 | 1.7 (-2.1 to 5.2) | 0.17 (-0.21 to 0.52) | -- | -- | ||
| High | 72.5 | 7.25 | 3.6 (-4.4 to 10.9) | 0.36 (-0.44 to 1.09) | -- | -- | ||
| Major GI bleeding | Low | 2.3 | 0.23 | -1.3 (-2.2 to -0.7) | -0.13 (-0.22 to -0.07) | -- | 7,692 (4,545 to 14,286) | |
| Med | 4.9 | 0.49 | -2.8 (-4.6 to -1.4) | -0.28 (-0.46 to -0.14) | -- | 3,571 (2,174 to 7,143) | ||
| High | 10.4 | 1.04 | -6.0 (-9.9 to -3.0) | -0.60 (-0.99 to -0.30) | -- | 1,667 (1,010 to 3,333) | ||
| ICH including hemorrhagic stroke | Low | 2.0 | 0.20 | -0.4 (-1.2 to 0.2) | -0.04 (-0.12 to 0.02) | -- | -- | |
| Med | 4.2 | 0.42 | -0.8 (-2.6 to 0.5) | -0.08 (-0.26 to 0.05) | -- | -- | ||
| High | 12.5 | 1.25 | -2.4 (-7.6 to 1.5) | -0.24 (-0.76 to 0.15) | -- | -- |
- *
Data from companion systematic review on CVD primary prevention41
- †
Only outcomes with statistically significant results had NNT calculated
- ‡
Minimum, maximum, and median control group rate for each outcome, excluding zeros and outliers, from the set of CVD primary prevention trials
Abbreviations: ARR = absolute risk reduction; ASA = acetylsalicylic acid; CI = confidence interval; CVD = cardiovascular disease; GI = gastrointestinal; ICH = intracranial hemorrhage; mg – milligram(S); MI = myocardial infarction; NNT-B = number need to treat to benefit; NNT-H = number need to treat to harm; p-y = person-years
- Table 10, Absolute Risk Reduction and Number Needed to Treat or Harm With ASA, C...Table 10, Absolute Risk Reduction and Number Needed to Treat or Harm With ASA, CVD Primary Prevention Trials - Aspirin Use in Adults: Cancer, All-Cause Mortality, and Harms
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