In Reply As stated in our article, there was a significant reduction in the incidence of nonfatal myocardial infarction and transient ischemic attacks, which were predefined secondary end points. Because we did not find a significant reduction in the primary end point, the study has to be interpreted as negative.
Further study including more patients or for longer periods may produce different results, as may analyzing ischemic stroke and intracranial hemorrhage separately. In addition, certain types of patients may benefit from aspirin for primary prevention.
Ikeda Y. Aspirin for Prevention of Cardiovascular Events in Older Japanese Patients—Reply. JAMA. 2015;313(14):1473. doi:10.1001/jama.2015.2577