Low-dose aspirin for primary prevention in persons with subclinical coronary heart disease: rationale for expanded use temporally related to onset of viral pandemics
Main Article Content
Abstract
Advances in risk stratification are foundational for enhanced primary cardiovascular prevention. Low-dose aspirin guided by coronary artery calcium scoring has accordingly been recommended for persons at risk due to subclinical coronary heart disease. Findings related to low-dose aspirin and cardiovascular outcomes during the recent SARS-COVID-19 pandemic are reviewed. The rationale for expanding such use in vulnerable elderly persons to mitigate the transiently elevated cardiac risk of viral epidemics is considered.
Keywords:
aspirin, primary cardiovascular prevention, viral pandemics
Article Details
How to Cite
SIEGEL, Arthur J..
Low-dose aspirin for primary prevention in persons with subclinical coronary heart disease: rationale for expanded use temporally related to onset of viral pandemics.
Medical Research Archives, [S.l.], v. 14, n. 1, jan. 2026.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/7162>. Date accessed: 03 feb. 2026.
doi: https://doi.org/10.18103/mra.v14i1.7162.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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14. Fras Z, Sahabkar A, BanachM. The use of aspirin and contemporary primary prevention of atherosclerotic cardiovascular disease revisited: Increasing need and call for a personalized therapeutic approach. American Journal of cardiovascular drugs. Published online 18 August 2020. https://doi.org/10.1007/s 40256-020-00424-y.
2. Siegel A. Pre-race aspirin to attenuate the risk for marathon-related cardiac arrest: deconstructing the legacy of Pheidippides. Eur Heart J. 2023, ehad641.
3. Siegel A. Aspirin guided by coronary artery calcium scoring for primary cardiovascular prevention in persons with subclinical coronary atherosclerosis. Am J Med 2025.138(4):591-593.
4. Siegel AJ. The rationale for aspirin use guided by coronary artery calcium scoring for primary prevention in persons with subclinical atherosclerotic coronary artery disease. Clin Cardiol. 2025;5(2):1036-1040.
5. TIPS-3 investigators. Polypill plus aspirin reduces incidence of cardiovascular events by 31%: TIPS-3 Cardiovasc J Afr. 2021;32(1):32-40.
6. Arnett DK, Claas SA. 2019ACC/AHA Guideline for prevention of CVD. J Am Coll Cardiol 2019;8(19):e01460.
7. Siegel AJ. Aspirin use for primary cardiovascular prevention during the COVID–19 pandemic. Am J Med. 2021-04.DOI: 10.1016/j.amjmed.2020.11.008.
8. Merzon E, Green I, Vinker S, et al. The use of aspirin for primary prevention of cardiovascular disease is associated with a lower likelihood of COVID-19 infection. FEBS@2021 Federation of European Biochemical Societies. DOI: 10.1111/febs.15784.
9. Botton J, Semenzato L, Dupouy J, et al. no association of low–dose aspirin with severe COVID-19 in France: A cohort of 31.1 million people without cardiovascular disease. Res Pract Thromb Heamost. 2022:6 e12743.
10. Martha JW, Pranata R, Lim MA, et al. Active prescription of low–dose aspirin during or prior to hospitalization and mortality in COVID-19: a systematic review and meta–analysis of adjusted effect estimates. International Journal of infectious diseases. 2021;108:6-12. DOI.org /10.1016/jijidi.2021.05.016.
11. Costa R, Castagna A, Torchia C, et al. COVID–19 and cardiovascular disease in elderly patients: a challenge in the challenge. Geriatric Care 2020; (6); 9121:48-52.
12. Ovalle D. Flu cases rising with a strain that makes older people sicker. Washington Post, January 1, 2026. Accessed online, January 3, 202.
13. Wolfe R, Broder JC, Zhou Z, et al. Aspirin, cardiovascular events and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. Published online. PMCID: PMC12596486.
14. Fras Z, Sahabkar A, BanachM. The use of aspirin and contemporary primary prevention of atherosclerotic cardiovascular disease revisited: Increasing need and call for a personalized therapeutic approach. American Journal of cardiovascular drugs. Published online 18 August 2020. https://doi.org/10.1007/s 40256-020-00424-y.