Format

Send to

Choose Destination
Clin Cardiol. 2017 Sep;40(9):732-739. doi: 10.1002/clc.22724. Epub 2017 May 18.

Aspirin and the risk of cardiovascular events in atherosclerosis patients with and without prior ischemic events.

Author information

1
Department of Medicine, University of Florida, Gainesville, Florida.
2
North Florida/South Georgia Veterans Health System, Gainesville, Florida.
3
Département Hospitalo-Universitaire FIRE, Université Paris Diderot, AP-HP, Hôpital Bichat, and INSERM U-1148, Paris, France.
4
FACT (French Alliance for Cardiovascular Clinical Trials), Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France.
5
Service de cardiologie, Hôpital Avicenne, AP-HP, and Université Paris 13, Bobigny, France.
6
National Heart and Lung Institute, Royal Brompton Hospital, Imperial College, London, United Kingdom.
7
Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts.

Abstract

BACKGROUND:

The benefit of aspirin among patients with stable atherosclerosis without a prior ischemic event is not well defined.

HYPOTHESIS:

Aspirin would be of benefit in outpatients with atherosclerosis with prior ischemic events, but not in those without ischemic events.

METHODS:

Subjects from the Reduction of Atherothrombosis for Continued Health registry were divided according to prior ischemic event (n =21 724) vs stable atherosclerosis, but no prior ischemic event (n = 11 872). Analyses were propensity score matched. Aspirin use was updated at each clinic visit and considered as a time-varying covariate. The primary outcome was the first occurrence of cardiovascular death, myocardial infarction, or stroke.

RESULTS:

In the group with a prior ischemic event, aspirin use was associated with a marginally lower risk of the primary outcome at a median of 41 months (hazard ratio [HR]: 0.81, 95% confidence interval [CI]: 0.65-1.01, P = 0.06). In the group without a prior ischemic event, aspirin use was not associated with a lower risk of the primary outcome at a median of 36 months (HR: 1.03, 95% CI: 0.73-1.45, P = 0.86).

CONCLUSIONS:

In this observational analysis of outpatients with stable atherosclerosis, aspirin was marginally beneficial among patients with a prior ischemic event; however, there was no apparent benefit among those with no prior ischemic event.

KEYWORDS:

Adverse Cardiovascular Events; Aspirin; Atherosclerosis; Coronary Artery Disease; Myocardial Infarction; Stable Ischemic Heart Disease

PMID:
28520215
DOI:
10.1002/clc.22724
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center