Key result
Aspirin fails to reduce major adverse cardiovascular events in vasospastic angina without significant stenosis.
Why the study?
The efficacy of aspirin use to prevent cardiovascular disease in vasospastic angina patients without significant stenosis had not been investigated.
Does aspirin use reduce major cardiovascular adverse events in patients with vasospastic angina without significant stenosis?
Meta-Analysis (n=3,661)
Yes
Does aspirin use reduce major cardiovascular adverse events in patients with vasospastic angina without significant stenosis?
Odds Ratio: 0.9 (95% CI 0.55–1.68)
p-value: p=0.829
Aspirin use does not significantly reduce the risk of major cardiovascular adverse events, myocardial infarction, or cardiac death in patients with vasospastic angina without significant stenosis.
Aspirin should not be routinely prescribed for MACE prevention in vasospastic angina without stenosis; leaves open the need for dedicated RCTs.
Objectives The use of aspirin to prevent cardiovascular disease in vasospastic angina (VSA) patients without significant stenosis has yet to be investigated. This study aimed to investigate the efficacy of aspirin use among VSA patients. Design Systematic review and meta-analysis. Data sources PubMed, Web of Science and Cochrane Central Register of Controlled Trials were searched for relevant information prior to October 2020. Eligibility criteria for selecting studies Aspirin use versus no aspirin use (placebo or no treatment) among VSA patients without significant stenosis. Data extraction and synthesis Two investigators extracted the study data. ORs and 95% CIs were calculated and graphed as forest plots. The Newcastle-Ottawa Quality Assessment Scale tool and Begg’s funnel plot were used to assess risk of bias. Results Four propensity-matched cohorts, one retrospective analysis and one prospective multicentre cohort, in total comprising 3661 patients (aspirin use group, n=1695; no aspirin use group, n=1966) were included in this meta-analysis. Aspirin use and the incidence of major cardiovascular adverse events with follow-up of 1–5 years were not significantly correlated (combined OR=0.90, 95% CI: 0.55 to 1.68, p=0.829, I2=82.2%; subgroup analysis: OR=1.09, 95% CI: 0.81 to 1.47, I2=0%). No significant difference was found between aspirin use and the incidence of myocardial infarction (OR=0.62, 95% CI: 0.09 to 4.36, p=0.615, I2=73.8%) or cardiac death (OR=1.73, 95% CI: 0.61 to 4.94, p=0.444, I2=0%) during follow-up. Conclusion Aspirin use may not reduce the risk of future cardiovascular events in VSA patients without significant stenosis. PROSPERO registration number CRD42020214891.
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Lin et al. (2021) conducted a meta-analysis in Vasospastic angina (VSA) without significant stenosis (n=3,661). Aspirin use vs. No aspirin use (placebo or no treatment) was evaluated on Incidence of major cardiovascular adverse events (OR 0.90, 95% CI 0.55-1.68, p=0.829). Aspirin use did not significantly reduce the incidence of major cardiovascular adverse events in vasospastic angina patients without significant stenosis (OR 0.90; 95% CI 0.55-1.68; p=0.829).
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