Curbside Consults Podcast

By Clement Lee, MD, MSc

Published July 28, 2022

In this episode of Curbside Consults, we examine the latest recommendation statement on the use of aspirin to prevent cardiovascular disease from the United States Preventive Services Task Force (USPSTF). We are joined by Dr. Michael Barry, who is Director of the Informed Medical Decisions Program in the Health Decision Sciences Center at Massachusetts General Hospital, Professor of Medicine at Harvard Medical School, and one of the guideline authors.

00:05 – Intro
00:44 – USPSTF guideline process
04:12 – New recommendations for aspirin
09:32 – Recent major aspirin trials
10:50 – ARRIVE trial
12:00 – ASPREE trial
12:49 – ASCEND trial
15:44 – Patients already taking aspirin
17:00 – Aspirin and colorectal cancer
18:45 – An example case
20:22 – Concluding remarks

Articles discussed in this episode:

1. US Preventative Services Task Force. Aspirin Use to Prevent Cardiovascular Disease. JAMA 2022.
2. Gaziano JM et al. Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial. Lancet 2018.
3. McNeil JJ et al. Effect of Aspirin on All-Cause Mortality in the Healthy Elderly. N Engl J Med 2018.
4. The ASCEND Study Collaborative Group. Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. N Engl J Med 2018.

The Curbside Consults series complements the foundational information in Rotation Prep by taking a deep dive into key clinical topics with expert clinicians and educators. These podcasts explore and critique the evidence behind clinical practice and break down statistical concepts for the busy clinical trainee.

Michael Barry, MD, is Director of the Informed Medical Decisions Program in the Health Decision Sciences Center and Professor of Medicine at Harvard Medical School.
Clement Lee, MD, MSc, is a 2021–2022 NEJM Editorial Fellow. He is currently an internal medicine hospitalist at Beth Israel Deaconess Medical Center and a pediatric hospitalist at Lowell General Hospital. He completed his internal medicine-pediatrics residency at Penn-CHOP.