Introduction:

Aspirin is currently the most widely used drug worldwide. During 2018, at least partially, the risk/benefit ratio of aspirin in primary prevention was questioned.

Objective:

To update the true risk/benefit value of aspirin in the primary prevention of cardiovascular diseases.

Methods:

A review of the papers published in the last five years, on the use of aspirin in the primary prevention of cardiovascular diseases, was carried out. Twenty publications were selected in Medline, Embase, and SciELO.

Discussion:

There are important, high-quality, randomized, independent studies that have questioned the quality of aspirin in primary prevention.

Results:

The first results of the THEMIS study will contribute to understanding the future role of antiplatelet agents in primary prevention as to avoid the consequences of atherosclerotic plaque rupture in patients with the possibility of suffering from asymptomatic atherosclerotic plaque rupture.

Conclusions:

The advantages of the use of aspirin as a primary prophylaxis of cardiovascular disease are ruled out, due to the frequent appearance of sometimes serious bleeding; however, aspirin continues to be proposed as a very useful medicine in secondary prophylaxis, in addition to promoting the use of statins.

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