Aspirin use and all-cause mortality among patients being evaluated for known or suspected coronary artery disease: A...

Area of Science:

• Cardiology
• Pharmacology
• Epidemiology

Background:

• Aspirin is known to reduce cardiovascular events and short-term mortality after myocardial infarction.
• The long-term impact of aspirin on all-cause mortality in stable coronary disease patients remains unclear.

Purpose of the Study:

• To investigate the association between aspirin use and long-term mortality in stable patients with coronary disease.
• To identify patient characteristics that predict the greatest mortality benefit from aspirin.

Main Methods:

• A prospective, observational cohort study of 6174 adults undergoing stress echocardiography (1990-1998).
• Exclusion criteria included valvular disease, contraindications to aspirin (peptic ulcer, renal insufficiency, NSAID use).
• All-cause mortality was assessed over a median follow-up of 3.1 years.

Main Results:

• Aspirin use was not initially associated with mortality in univariable analysis (4.5% vs 4.5%).
• After multivariable adjustment and propensity score matching, aspirin use was significantly associated with reduced mortality (adjusted HR, 0.56; P<.001).
• Greatest mortality reduction observed in older patients, those with known coronary artery disease, and impaired exercise capacity.

Conclusions:

• Aspirin use is independently linked to lower long-term all-cause mortality in patients undergoing stress echocardiography.
• The benefits are most pronounced in older patients, those with established coronary artery disease, and those with reduced exercise capacity.