A
ntiplatelet age
nts are widely used i
n primary a
nd seco
ndary preve
ntio
n of cardiovascular eve
nts. The scie
ntific evide
nce has provided stro
ng support for the be
nefits of aspiri
n i
n decreasi
ng the risk of cardiovascular eve
nts i
n a wide ra
nge of pathologies. The relatively rare occurre
nce of major bleedi
ng complicatio
ns should
not be u
nderestimated, mai
nly due to its high morbi-mortality. The assessme
nt of both gastroi
ntesti
nal risk a
nd cardiovascular be
nefits of low-dose aspiri
n for a
ny i
ndividual patie
nt may be difficult i
n cli
nical practice.
In this review, we summarize the evidence supporting the efficacy of aspirin and the risks of side effects due to hemorrhagic complications. This article proposes a unifying framework for application to help the clinician in the decision making process of individuals who have different risk of cardiovascular and bleeding events with different examples. Finally, new developments in the field directed towards individualized risk assessment strategies are described.