Low-dose aspirin for primary prevention in persons with subclinical coronary heart disease: rationale for expanded use temporally related to onset of viral pandemics

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.