Yes, Its “evidence-based fun”. Forget all those anti-platelet trial dramas … showing in the cardiovascular theatres near you . There is only one genuine drug , that’s the good old humble Aspirin . Mind you ,none of other actors can ever be imagined for primary prevention.
By the way , there is absolutely no controversy for the role of Aspirin in secondary prevention after established CAD.(We know , how Aspirin has taken up a critically Integral role in saving the life of the stents as well as patients, post PCI)
Oh , what a disgrace for this drug when it comes out of the glamorous cath lab zones. Its use is often frowned upon for preventing simple CAD. (All due to a single factor, fear of bleeding ? No , its exaggerated in most studies)
Overlap between Primary and Secondary prevention
In primary prevention of CAD , what do we attempt to prevent? How do you differentiate established CAD from “Established coronary atherosclerosis but Non-established CAD ?”
The fundamental flaw in this perceived controversy is in our inability to define what is significant CAD in the asymptomatic population.Do we need a clinical event to say, established CAD?
For the attention of evidence-based script writers , a long query . . .
“How much evidence we have to conclude , that a patient with manifest clinical CAD carry more risk for a recurrence than an asymptomatic high-risk patient who is likely to develop the first clinical event (which happens with a bang that could be a major ACS ) due to underlying silent Atherosclerosis.?
Reference
Click here to for more unscientific review on primary prevention of CVD.
Dr.S.Venkatesan MD 