Low-dose aspirin for primary revention of cardiovascular disease: Use patterns and impact across race and ethnicity in the southern community cohort study
Entity
UAM. Departamento de MedicinaPublisher
Behalf of the American Heart Association, Inc., by WileyDate
2019Citation
10.1161/JAHA.119.013404
Journal American Heart Association 8 (2019): e013404
ISSN
2047-9980DOI
10.1161/JAHA.119.013404Funded by
The SCCS (Southern Community Cohort Study) is funded by grants R01 CA092447 and U01 CA202979 from the National Cancer Institute, including American Recovery and Reinvestment Act funding (3R01 CA029447-08 S1). Data collection was performed by the Survey and Biospecimen Shared Resource, which is supported in part by the Vanderbilt– Ingram Cancer Center (P30 CA68485). This analysis forms part of a project that has received funding from the American Heart Association under grant no. 14SFRN20490315. Fernandez- Jimenez is a recipient of funding from the European Union Horizon 2020 Research and Innovation Program under the Marie Skłodowska-Curie grant agreement no. 707642. The Centro Nacional de Investigaciones Cardiovasculares (CNIC) is supported by the Instituto de Salud Carlos III; the Ministerio de Ciencia, Innovaci on y Universidades; and the Pro CNIC Foundation and is a Severo Ochoa Center of Excellence (SEV-2015-0505).Editor's Version
https://doi.org/10.1161/JAHA.119.013404Subjects
Aspirin; Ethnicity; Ischemic heart disease; Primary prevention; MedicinaRights
© 2019 The AuthorsEsta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
Abstract
Background-—Data are limited on use patterns of low-dose aspirin and its role for primary prevention of cardiovascular disease
(CVD) in different racial and ethnic groups.
Methods and Results-—Overall, 65 231 non-Hispanic black and white people aged 40 to 79 years with no history of CVD enrolled
from 2002 through 2009 in the SCCS (Southern Community Cohort Study). At cohort entry, the simplified Framingham 10-year
CVD risk was calculated, and data related to low-dose aspirin use and clinical and socioeconomic covariates were collected. Raceand
ethnicity-specific adjusted odds ratios for characteristics of low-dose aspirin users and hazard ratios for ischemic cardiac
death according to aspirin use were calculated using multivariate logistic and Cox regression models. Black participants were less
likely to take low-dose aspirin compared with white participants, regardless of CVD risk and covariates (adjusted odds ratio: 0.79;
95% CI, 0.75–0.82). Over a median follow-up of 11.3 years, low-dose aspirin use was associated with a trend toward decreased
risk of ischemic cardiac death in white participants (adjusted hazard ratio: 0.86; 95% CI, 0.68–1.10), especially in women (adjusted
hazard ratio: 0.72; 95% CI, 0.51–1.02), but not in black participants (adjusted hazard ratio: 1.18; 95% CI, 0.98–1.40). Similar trends
were observed when the analysis was restricted to high-risk individuals aged 50 to 69 or 50 to 59 years, ages for which guidelines
consider aspirin for CVD primary prevention.
Conclusions-—Low-dose aspirin use for primary prevention of CVD is lower among black than white patients. Its use might be
associated with a disparate impact on ischemic cardiac death according to race and ethnicity. Although additional studies are
required, these findings provide no evidence of a beneficial effect of aspirin among black patients
Files in this item
Google Scholar:Fernández-Jiménez, Rodrigo
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Wang, Thomas J.
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Fuster, Valentín
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Blot, William J.
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