Discontinuation of low-dose aspirin in long-term users was associated with a higher rate of cardiovascular events compared to continuation (HR 1.37; 95% CI 1.34-1.41).
Cohort (n=601,527)
Does discontinuation of low-dose aspirin increase the risk of cardiovascular events in long-term adherent users?
Discontinuation of low-dose aspirin in long-term adherent users without major surgery or bleeding is associated with a 37% increased risk of cardiovascular events.
Effect estimate: HR 1.37 (95% CI 1.34-1.41)
BACKGROUND: There are increasing concerns about risks associated with aspirin discontinuation in the absence of major surgery or bleeding. We investigated whether long-term low-dose aspirin discontinuation and treatment gaps increase the risk of cardiovascular events. METHODS: We performed a cohort study of 601 527 users of low-dose aspirin for primary or secondary prevention in the Swedish prescription register between 2005 and 2009 who were >40 years of age, were free from previous cancer, and had ≥80% adherence during the first observed year of treatment. Cardiovascular events were identified with the Swedish inpatient and cause-of-death registers. The first 3 months after a major bleeding or surgical procedure were excluded from the time at risk. RESULTS: During a median of 3.0 years of follow-up, 62 690 cardiovascular events occurred. Patients who discontinued aspirin had a higher rate of cardiovascular events than those who continued (multivariable-adjusted hazard ratio, 1.37; 95% confidence interval, 1.34-1.41), corresponding to an additional cardiovascular event observed per year in 1 of every 74 patients who discontinue aspirin. The risk increased shortly after discontinuation and did not appear to diminish over time. CONCLUSIONS: In long-term users, discontinuation of low-dose aspirin in the absence of major surgery or bleeding was associated with a >30% increased risk of cardiovascular events. Adherence to low-dose aspirin treatment in the absence of major surgery or bleeding is likely an important treatment goal.
Sundström et al. (Mon,) conducted a cohort in Primary or secondary cardiovascular prevention (n=601,527). Aspirin discontinuation vs. Aspirin continuation was evaluated on Cardiovascular events (HR 1.37, 95% CI 1.34-1.41). Discontinuation of low-dose aspirin in long-term users was associated with a higher rate of cardiovascular events compared to continuation (HR 1.37; 95% CI 1.34-1.41).