Discontinuation of low-dose aspirin for primary prevention was associated with a higher risk of cardiovascular disease compared to continuation (adjusted HR 1.72; 95% CI 1.06-2.80).
Observational
No
Does discontinuation of low-dose aspirin increase cardiovascular disease risk in Thai adults using it for primary prevention?
Discontinuation of low-dose aspirin for primary prevention in Thai adults is associated with a significantly increased risk of cardiovascular disease, particularly in short-term users and those with diabetes.
Effect estimate: adjusted HR 1.72 (95% CI 1.06-2.80)
BACKGROUND: The role of aspirin for primary prevention remains debated, especially around discontinuation in Thailand. Western studies suggest higher cardiovascular risk after cessation, but Southeast Asian evidence is limited and may differ. OBJECTIVE: To determine the association between aspirin discontinuation and cardiovascular disease (CVD) risk among Thai adults using low-dose aspirin for primary prevention, and to explore patient and clinician perspectives underlying discontinuation. METHODS: We conducted a descriptive study at Phramongkutklao Hospital (2014-2024). The index date was aspirin initiation; follow-up accrued from the next day until first outcome, death, last encounter, or 31 Dec 2024. Aspirin exposure was modeled time-varyingly: person-time counted as continued until protocol-defined discontinuation (≥ 90-day gap after the expected end of supply) and as discontinued thereafter. Adults prescribed low-dose aspirin (75-162 mg/day) for primary prevention were included ( RESULTS: Discontinuation was associated with higher CVD risk (adjusted HR 1.72, 95% CI 1.06-2.80; CONCLUSION: Stopping aspirin was linked to increased cardiovascular risk-particularly among short-term users and patients with diabetes, with similar but non-significant trends observed in those with hypertension or dyslipidemia. Qualitative insights highlight pragmatic solutions-clear restart plans, aligned clinician messaging, and concise risk-framing-to support individualized decisions in Thai outpatient care.
Phakwiwat et al. (Wed,) conducted a observational in Primary prevention of cardiovascular disease. Aspirin discontinuation vs. Aspirin continuation was evaluated on Cardiovascular disease (CVD) risk (adjusted HR 1.72, 95% CI 1.06-2.80). Discontinuation of low-dose aspirin for primary prevention was associated with a higher risk of cardiovascular disease compared to continuation (adjusted HR 1.72; 95% CI 1.06-2.80).