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

for the REACH Registry Investigators

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)732-739
Number of pages8
JournalClinical Cardiology
Volume40
Issue number9
DOIs
StatePublished - Sep 2017
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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