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Low-Dose Aspirin Discontinuation and Risk of Cardiovascular Events A Swedish Nationwide, Population-Based Cohort Study
Uppsala University, Sweden.
Uppsala University, Sweden.
Statisticon AB, Sweden.
AstraZeneca Nordic Balt, Sweden.
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2017 (English)In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 136, no 13, 1183-+ p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: There are increasing concerns about risks associated with aspirin discontinuation in the absence of major surgery or bleeding. We investigated whether long-term low-dose aspirin discontinuation and treatment gaps increase the risk of cardiovascular events. METHODS: We performed a cohort study of 601 527 users of low-dose aspirin for primary or secondary prevention in the Swedish prescription register between 2005 and 2009 who were amp;gt;40 years of age, were free from previous cancer, and had amp;gt;= 80% adherence during the first observed year of treatment. Cardiovascular events were identified with the Swedish inpatient and cause-of-death registers. The first 3 months after a major bleeding or surgical procedure were excluded from the time at risk. RESULTS: During a median of 3.0 years of follow-up, 62 690 cardiovascular events occurred. Patients who discontinued aspirin had a higher rate of cardiovascular events than those who continued (multivariable-adjusted hazard ratio, 1.37; 95% confidence interval, 1.34-1.41), corresponding to an additional cardiovascular event observed per year in 1 of every 74 patients who discontinue aspirin. The risk increased shortly after discontinuation and did not appear to diminish over time. CONCLUSIONS: In long-term users, discontinuation of low-dose aspirin in the absence of major surgery or bleeding was associated with a amp;gt;30% increased risk of cardiovascular events. Adherence to low-dose aspirin treatment in the absence of major surgery or bleeding is likely an important treatment goal.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2017. Vol. 136, no 13, 1183-+ p.
Keyword [en]
aspirin; cohort studies; primary prevention; secondary prevention
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-142179DOI: 10.1161/CIRCULATIONAHA.117.028321ISI: 000411567600004PubMedID: 28947478OAI: oai:DiVA.org:liu-142179DiVA: diva2:1151548
Note

Funding Agencies|AstraZeneca

Available from: 2017-10-23 Created: 2017-10-23 Last updated: 2017-10-23

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CiteExportLink to record
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Citation style
  • apa
  • harvard1
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  • modern-language-association-8th-edition
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  • Other style
More styles
Language
  • de-DE
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  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
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  • asciidoc
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