Aspirin for primary prevention in patients with high cardiovascular risk: insights from CORE-Thailand registry
Abstract Aspirin may be considered for primary prevention in non-elderly patients with high cardiovascular risk. However, contemporary management aimed at aggressive cardiovascular risk factor control may alter benefit-risk ratio of aspirin. Therefore, we aimed to examine the effect of aspirin for p...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-09-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-41864-1 |
| _version_ | 1797453084672131072 |
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| author | Wanwarang Wongcharoen Nichanan Osataphan Narawudt Prasertwitayakij Pannipa Suwannasom Swangjit Suraamornkul Wattana Wongtheptian Siriluck Gunaparn Wachiranun Sirikul Arintaya Phrommintikul |
| author_facet | Wanwarang Wongcharoen Nichanan Osataphan Narawudt Prasertwitayakij Pannipa Suwannasom Swangjit Suraamornkul Wattana Wongtheptian Siriluck Gunaparn Wachiranun Sirikul Arintaya Phrommintikul |
| author_sort | Wanwarang Wongcharoen |
| collection | DOAJ |
| description | Abstract Aspirin may be considered for primary prevention in non-elderly patients with high cardiovascular risk. However, contemporary management aimed at aggressive cardiovascular risk factor control may alter benefit-risk ratio of aspirin. Therefore, we aimed to examine the effect of aspirin for primary prevention on the long-term MACEs in a large cohort registry. Cohort Of patients with high Risk for cardiovascular Events (CORE-Thailand) registry is a prospective, multicenter, observational, longitudinal study of Thai patients with high atherosclerotic risk. Patients with established atherosclerotic cardiovascular diseases were excluded. Among 4259 patients with multiple cardiovascular risk factors, 1945 (45.7%) patients used aspirin. After propensity score matching, there were 3228 patients remained in post-matching analysis. During the median follow-up period of 58.2 months, we demonstrated that aspirin use increased risk of long-term MACEs in pre-matching cohort (unadjusted HR 1.76, 95% CI 1.43–2.17, P < 0.001) and post-matching cohort (HR 1.66 (1.31–2.10), P < 0.001). In addition, patients taking aspirin had a higher risk of bleeding than non-aspirin users in pre-matching cohort (unadjusted HR 2.28, 95% CI 1.09–4.75, P = 0.028). We demonstrated that aspirin was associated with increased risk of long-term MACEs in patients with multiple cardiovascular risk factors. Due to the non-randomized design, our results should be interpreted with caution. |
| first_indexed | 2024-03-09T15:16:54Z |
| format | Article |
| id | doaj.art-bc4288e24b4f4dd399918dd562ec2647 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-09T15:16:54Z |
| publishDate | 2023-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-bc4288e24b4f4dd399918dd562ec26472023-11-26T13:01:54ZengNature PortfolioScientific Reports2045-23222023-09-011311810.1038/s41598-023-41864-1Aspirin for primary prevention in patients with high cardiovascular risk: insights from CORE-Thailand registryWanwarang Wongcharoen0Nichanan Osataphan1Narawudt Prasertwitayakij2Pannipa Suwannasom3Swangjit Suraamornkul4Wattana Wongtheptian5Siriluck Gunaparn6Wachiranun Sirikul7Arintaya Phrommintikul8Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityFaculty of Medicine Vajira Hospital, Navamindradhiraj UniversityDivision of Cardiology, Department of Internal Medicine, Chiang Rai Prachanukroh HospitalDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityDepartment of Community Medicine, Faculty of Medicine, Chiang Mai UniversityDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityAbstract Aspirin may be considered for primary prevention in non-elderly patients with high cardiovascular risk. However, contemporary management aimed at aggressive cardiovascular risk factor control may alter benefit-risk ratio of aspirin. Therefore, we aimed to examine the effect of aspirin for primary prevention on the long-term MACEs in a large cohort registry. Cohort Of patients with high Risk for cardiovascular Events (CORE-Thailand) registry is a prospective, multicenter, observational, longitudinal study of Thai patients with high atherosclerotic risk. Patients with established atherosclerotic cardiovascular diseases were excluded. Among 4259 patients with multiple cardiovascular risk factors, 1945 (45.7%) patients used aspirin. After propensity score matching, there were 3228 patients remained in post-matching analysis. During the median follow-up period of 58.2 months, we demonstrated that aspirin use increased risk of long-term MACEs in pre-matching cohort (unadjusted HR 1.76, 95% CI 1.43–2.17, P < 0.001) and post-matching cohort (HR 1.66 (1.31–2.10), P < 0.001). In addition, patients taking aspirin had a higher risk of bleeding than non-aspirin users in pre-matching cohort (unadjusted HR 2.28, 95% CI 1.09–4.75, P = 0.028). We demonstrated that aspirin was associated with increased risk of long-term MACEs in patients with multiple cardiovascular risk factors. Due to the non-randomized design, our results should be interpreted with caution.https://doi.org/10.1038/s41598-023-41864-1 |
| spellingShingle | Wanwarang Wongcharoen Nichanan Osataphan Narawudt Prasertwitayakij Pannipa Suwannasom Swangjit Suraamornkul Wattana Wongtheptian Siriluck Gunaparn Wachiranun Sirikul Arintaya Phrommintikul Aspirin for primary prevention in patients with high cardiovascular risk: insights from CORE-Thailand registry Scientific Reports |
| title | Aspirin for primary prevention in patients with high cardiovascular risk: insights from CORE-Thailand registry |
| title_full | Aspirin for primary prevention in patients with high cardiovascular risk: insights from CORE-Thailand registry |
| title_fullStr | Aspirin for primary prevention in patients with high cardiovascular risk: insights from CORE-Thailand registry |
| title_full_unstemmed | Aspirin for primary prevention in patients with high cardiovascular risk: insights from CORE-Thailand registry |
| title_short | Aspirin for primary prevention in patients with high cardiovascular risk: insights from CORE-Thailand registry |
| title_sort | aspirin for primary prevention in patients with high cardiovascular risk insights from core thailand registry |
| url | https://doi.org/10.1038/s41598-023-41864-1 |
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