Aspirin use is associated with increased risk for incident heart failure: a patient-level pooled analysis

Area of Science:

• Cardiology
• Preventive Medicine
• Pharmacology

Background:

• Recent trials indicate limited benefits of aspirin for primary cardiovascular disease prevention.
• The specific impact of aspirin on incident heart failure (HF) risk remains unclear.
• Existing research has not definitively established whether aspirin use elevates HF risk.

Purpose of the Study:

• To investigate the association between aspirin use and incident HF in both primary and secondary prevention contexts.
• To determine if aspirin use increases the risk of developing HF in at-risk populations.
• To provide evidence-based recommendations for aspirin prescription in HF patients.

Main Methods:

• Analysis of data from 30,827 patients at risk for HF across six observational studies.
• Recording of baseline cardiovascular risk factors and aspirin use.
• Assessment of incident fatal or non-fatal HF over a median follow-up of 5.3 years.
• Utilization of multivariable-adjusted proportional hazard regression and propensity-score matching to analyze associations.

Main Results:

• Aspirin use was associated with a significantly increased risk of incident HF (Hazard Ratio [HR] = 1.26; P ≤ 0.001).
• This association persisted in propensity-score-matched analyses and in patients without a prior history of cardiovascular disease.
• The increased risk of HF associated with aspirin was independent of other cardiovascular risk factors.

Conclusions:

• Aspirin use is associated with incident heart failure in at-risk patients.
• The findings suggest that aspirin should be prescribed cautiously in individuals at risk of or with existing heart failure.
• Further clinical trials are warranted to confirm these observational findings and refine treatment guidelines.