This "evidence" is highly questionable. There's other evidence, i.e., that taking aspirin with DGL or vitamin C does not damage the stomach lining, have led to new formulations decades ago. In fact, high doses of aspirin have been sold in Europe combined with vitamin C for as long as I remember - Aspirin C by Bayer and Upsarin C by UPSA. There's other evidence, too, that aspirin protects against cancer.
I haven't heard about it, but the combo would have a synergistic effect as they both address different coagulation pathways. I take them together for other reasons - I take vitamin K (K1, and K2 in MK-4 and K2 MK-7 forms) to direct calcium to the bones, not to the tissues, and, of course, anticollagulation. For the latter, I also take Nattokinase, but the main reason I take Aspirin is its protection against cancer.
Sounds like you have additional and better evidence than the USPTF that made the changes in aspirin for primary prevention. They do have a method to give feedback, and based on my experience a person will respond to you personally. I suggest you submit your information to them.
Low-dode aspirin wrecks the stomach or small intestine anyway in many individuals, irrespective of its form. This strikes a lot sooner than internal bleeding. Both the chewable and the enteric-coated forms cause this injury at separate locations.
One just finds out by trial and error, although the injury can take many months to manifest, and is slowly reversible upon cessation. As for the safer pharmaceutical alternative, clopidogrel is it, again in a sufficiently low dose, but it is not OTC.
Its probably best to talk to your doctor about a CAC score. I don't know if its possible to tell stable vs unstable plaque yet, but a higher CAC score may benefit from aspirin.
Patients with conditions that would indicate aspirin use for secondary prevention (such as coronary artery disease, prior stroke, or peripheral artery disease) as well as those for whom aspirin was contraindicated due to allergy or pregnancy were excluded.
So they excluded "coronary artery disease, prior stroke, or peripheral artery disease" which covers most people that might be prescribed aspirin? Who's left?
https://www.uspreventiveservicestaskforce.org/uspstf/public-...
So then why are we not working to determine which individuals it is suitable for?
What is the alternative to aspirin for this use case and who benefits?
Is this due to the stomach being empty? Does taking it at the end of a large meal better?