Aspirin as Primary Prevention of Acute Coronary Heart Disease Events.
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Date
2014-12-01
Journal Title
Journal ISSN
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Abstract
Background/Objective: Aspirin for primary prophylaxis is controversial. This study
evaluated associations between prophylactic aspirin use and incident acute coronary
heart disease (CHD) events.
Methods and Results: The Reasons for Geographic and Racial Differences in Stroke
(REGARDS) Study was accessed for aspirin use examining black and white hazards for
incident CHD, for men and women, each adjusting incrementally for sampling, sociodemographics,
and CHD risk factors. Stratified models examined risks across strata of
the Framingham risk score, and all-cause mortality. 23,949 participants (mean 64 yo),
had 503 incident events over a 3.5 year follow-up. Prophylactic aspirin use was not
associated with incident acute CHD, HR 1.05 (95% CI 0.86, 1.29). Modeling had little
impact on the HR (1.09 {95% CI 0.89, 1.33) nor did the addition of risk factors (HR 1.00
{95% CI 0.81, 1.23). Aspirin use was not associated with incident CHD for any
Framingham risk level. Findings were similar when including all aspirin users (not just
those taking aspirin prophylactically), and when examining associations with all-cause
mortality. There was no excess hospitalized bleeding in the aspirin users. Conclusion: Aspirin was not associated with lower risk for incident acute CHD overall,
or within race, gender, or Framingham Risk Score.
Description
Keywords
Aspirin, prophylaxis, incident, coronary, heart, disease
Citation
Glasser Stephen P, Hovater Martha , Brown Todd M, Howard George, Safford Monika M. Aspirin as Primary Prevention of Acute Coronary Heart Disease Events.British Journal of Medicine and Medical Research. 2014 Dec; 4(34): 5357-5367.