PMID- 31755069
OWN - NLM
STAT- MEDLINE
DCOM- 20200513
LR  - 20200513
IS  - 1179-1969 (Electronic)
IS  - 1170-229X (Linking)
VI  - 37
IP  - 1
DP  - 2020 Jan
TI  - Efficacy of Aspirin in the Primary Prevention of Cardiovascular Diseases and 
      Cancer in the Elderly: A Population-Based Cohort Study in Korea.
PG  - 43-55
LID - 10.1007/s40266-019-00723-3 [doi]
AB  - INTRODUCTION: Aspirin is widely used to prevent cardiovascular diseases (CVDs). 
      However, the balance of its benefits and risks in the primary prevention of CVDs 
      and cancer is unclear, especially in elderly Asians. The present study aimed to 
      evaluate the efficacy of aspirin in the primary prevention of major adverse 
      cardiac and cerebrovascular events (MACCE), bleeding risk, and cancer in elderly 
      Koreans with cardiovascular (CV) risk factors. METHODS: This retrospective cohort 
      study used data from the Korean National Health Insurance Service-Senior cohort 
      database (2002-2015). Patients aged 60-90 years with hypertension, type 2 
      diabetes mellitus (T2DM), or dyslipidemia were identified. Aspirin users were 
      compared with non-users using propensity score matching at a 1:3 ratio. The 
      primary outcome was MACCE, a composite of CV mortality, myocardial infarction, 
      and ischemic stroke. The secondary outcomes were the components of MACCE, 
      all-cause mortality, angina pectoris, heart failure, the incidence and mortality 
      of cancer, and the risks of hemorrhagic stroke and gastrointestinal bleeding. 
      Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a Cox 
      proportional hazard model. RESULTS: A total of 3366 aspirin users and 10,089 
      non-users were finally included in the study. During a mean follow-up of 
      7.8 years, the incidence of MACCE was 15.2% in aspirin users and 22.4% in 
      non-users. The risk of MACCE was significantly lower in aspirin users than in 
      non-users (HR 0.76; 95% CI 0.69-0.85), and this risk was significantly reduced in 
      patients using aspirin over 5 years (HR 0.52; 95% CI 0.46-0.60). Aspirin use was 
      associated with a 21% reduction in the risk of primary cancer (HR 0.79; 95% CI 
      0.70-0.88) and cancer-related mortality (HR 0.72; 95% CI 0.61-0.84). No 
      significant differences in bleeding risks were observed between the two groups. 
      CONCLUSION: Aspirin reduced the risks of MACCE and cancer without increasing the 
      bleeding risk in elderly Koreans with hypertension, T2DM, or dyslipidemia. 
      Moreover, the benefits of the long-term use of aspirin in reducing the risks of 
      MACCE were demonstrated. However, the decision of using aspirin for primary 
      prevention must be carefully made on an individual basis, while estimating the 
      benefit-risk balance of aspirin.
FAU - Jung, Minji
AU  - Jung M
AUID- ORCID: 0000-0002-5489-827X
AD  - Division of Clinical Pharmacy, College of Pharmacy, Ajou University, 206 
      Worldcup-ro Yeongtong-gu, Suwon, 16499, Republic of Korea.
FAU - Lee, Sukhyang
AU  - Lee S
AUID- ORCID: 0000-0002-8830-4353
AD  - Division of Clinical Pharmacy, College of Pharmacy, Ajou University, 206 
      Worldcup-ro Yeongtong-gu, Suwon, 16499, Republic of Korea. suklee@ajou.ac.kr.
LA  - eng
PT  - Journal Article
PL  - New Zealand
TA  - Drugs Aging
JT  - Drugs & aging
JID - 9102074
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aspirin/adverse effects/*therapeutic use
MH  - Cardiovascular Diseases/*prevention & control
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 2/prevention & control
MH  - Dyslipidemias/prevention & control
MH  - Female
MH  - Hemorrhage/chemically induced
MH  - Humans
MH  - Hypertension/prevention & control
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*prevention & control
MH  - Primary Prevention/*methods
MH  - Proportional Hazards Models
MH  - Republic of Korea
MH  - Retrospective Studies
MH  - Risk Assessment
EDAT- 2019/11/23 06:00
MHDA- 2020/05/14 06:00
CRDT- 2019/11/23 06:00
PHST- 2019/11/23 06:00 [pubmed]
PHST- 2020/05/14 06:00 [medline]
PHST- 2019/11/23 06:00 [entrez]
AID - 10.1007/s40266-019-00723-3 [pii]
AID - 10.1007/s40266-019-00723-3 [doi]
PST - ppublish
SO  - Drugs Aging. 2020 Jan;37(1):43-55. doi: 10.1007/s40266-019-00723-3.