Aspirin should be used for the prevention of cardiovascular (CV) events by the risk-benefit balance. This study was conducted to clarify CV and
bleeding events in Japanese
aspirin users with a history of CV diseases. This study was a prospective, nationwide, multicenter cooperative registry of Japanese patients with CV diseases at risk of
thromboembolism who were taking
aspirin (75-325 mg) for at least 1 year. We observed major CV and
bleeding events during follow-up. Patients with history of
ischemic stroke (IS),
transient ischemic attack (TIA),
coronary artery disease (CAD),
atrial fibrillation (AF), and
venous thromboembolism (VTE) were included and analyzed in this sutdy. CV events included IS, TIA, CAD, CV death, angioplasty or stenting, and hospitalization because of CV disease.
Bleeding events included major
bleeding requiring hospitalization and/or
blood transfusion. A total of 1506 patients were categorized into IS/TIA (N = 540), CAD (N = 632), and AF/VTE (N = 232). Among them, 101 patients had two or more categories. CV and
bleeding events occurred in 61 (3.82%/year) and 15 patients (0.93%/year), respectively. The annual rates of CV and
bleeding events were 2.81% and 0.93% in IS/TIA, 5.32% and 0.75% in CAD, 1.15% and 1.15% in AF/VTE, and 6.44% and 0.91% in two or more disease categories, respectively. The Management of
Aspirin-induced Gastrointestinal Complications (MAGIC) study clarified the rates of major CV and
bleeding events with long-term use of
aspirin in patients with prior CV diseases in real-world clinical practice. The risk-benefit balance of
aspirin was acceptable in patients with IS/TIA, CAD, and multiple CV diseases but not in those with AF/VTE.Trial Registration: The MAGIC Study is registered at UMIN Clinical Trial Registry (www.umin.ac.jp/ctr/index-j.htm), number UMIN000000750.