Low- or high-dose preventive aspirin use and risk of death from all-cause, cardiovascular disease, and cancer: A nationally representative cohort study

Chen, Yu; Chen, Fuli; Liao, Jie; Han, Hukui; Li, Gang; Zhou, Long

doi:10.3389/fphar.2023.1099810

Cited by 9 publications

(7 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, it does not impair renal function ( Pierucci et al, 1989 ). In the present study, high-dose aspirin may increase the risk of blood transfusion and was associated with increased mortality in AKI patients compared to low-dose aspirin, which is consistent with the previous study ( Xian et al, 2015 ; Chen et al, 2023 ). Therefore, a low-dose aspirin use seems to be safer in patients with AKI.…”

Section: Discussionsupporting

confidence: 93%

Aspirin intervention before ICU admission reduced the mortality in critically ill patients with acute kidney injury: results from the MIMIC-IV

Meng,

Lin,

Zhang

et al. 2023

Front. Pharmacol.

View full text Add to dashboard Cite

Background: Aspirin, with its pleiotropic effects such as anti-inflammatory and anti-platelet aggregation, has been widely used for anti-inflammatory, analgesic, and cardiovascular diseases. However, the association between the use of aspirin before the intensive care unit (ICU) and clinical outcomes in critically ill patients with acute kidney injury (AKI) is unknown.Methods: Patients with AKI in this retrospective observational study were selected from the Marketplace for Medical Information in Intensive Care IV (MIMIC-IV). The association between aspirin intervention and 30-day mortality was assessed using Cox proportional hazards model. Logistic regression models were used to assess the association of aspirin intervention with the risks of intracranial hemorrhage, gastrointestinal bleeding and blood transfusion. The propensity score matching (PSM) method was adopted to balance the baseline variables. Sensitivity analysis was performed to validate the results by multiple interpolations for the missing data.Results: The study included 4237 pre-ICU aspirin users and 9745 non-users. In multivariate models, we found a decreased risk of mortality in those who received aspirin before ICU compared to those who did not (30-day:hazard ratio [HR], 0.70; 95% CI, 0.62–0.79; p < 0.001; 90-day:HR, 0.70; 95% CI, 0.63–0.77, p < 0.001; 180-day:HR, 0.72; 95%CI,0.65–0.79, p < 0.001). This benefit was consistent in the post-PSM analyses, sensitivity analyses, and subgroup analyses. Moreover, aspirin intervention was associated with a reduced risk of intracranial hemorrhage and gastrointestinal bleeding (HR, 0.16; 95% CI, 0.10–0.25; p < 0.001; HR, 0.59; 95% CI, 0.38–0.88, p = 0.012) after being adjusted by relating covariates, whereas with a increased risk of blood transfusion (HR, 1.28; 95% CI, 1.16–1.46; p < 0.001).Conclusion: Patients with AKI treated with aspirin before ICU admission might have reduced 30-day, 90-day and 180-day mortality without increasing the risk of intracranial hemorrhage (ICH) or gastrointestinal bleeding, but may increase the risk of transfusion.

show abstract

Section: Discussionsupporting

confidence: 93%

Aspirin intervention before ICU admission reduced the mortality in critically ill patients with acute kidney injury: results from the MIMIC-IV

Meng,

Lin,

Zhang

et al. 2023

Front. Pharmacol.

View full text Add to dashboard Cite

show abstract

“…Similar to our study, all the epidemiological studies that reported no association included almost exclusively low dose-aspirin users [ 17 – 20 ], while neither the Iowa Women’s Health Study nor the Nurses’ Health Study restricted their questionnaires to users of low-dose aspirin, nor did they collect information on the dose of aspirin for the surveys used in the studies by Blair et al and Holmes et al [ 14 , 15 ]. Aspirin in higher doses is rarely used in Norway [ 53 ], but more frequently used in the USA [ 54 ]. Therefore, it is possible that the Iowa Women’s Health Study and the Nurses’ Health Study included a non-neglectable proportion of users of aspirin in higher doses.…”

Section: Discussionmentioning

confidence: 99%

Low-dose aspirin, statins, and metformin and survival in patients with breast cancers: a Norwegian population-based cohort study

Löfling,

Støer,

Andreassen

et al. 2023

Breast Cancer Res

View full text Add to dashboard Cite

Background Previous studies assessed the prognostic effect of aspirin, statins, and metformin in breast cancer (BC) patients, with inconclusive results. Methods We performed a nationwide population-based cohort study to evaluate if post-diagnostic use of low-dose aspirin, statins, and metformin was associated with BC-specific survival. Women aged ≥ 50 years and diagnosed with BC in 2004–2017, who survived ≥ 12 months after diagnosis (follow-up started 12 months after diagnosis), were identified in the Cancer Registry of Norway. The Norwegian Prescription Database provided information on prescriptions. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between post-diagnostic use and BC-specific survival, overall and by oestrogen receptor (ER) status. Results A total of 26,190 patients were included. Of these, 5324 (20%), 7591 (29%), and 1495 (6%) were post-diagnostic users of low-dose aspirin, statins, and metformin, respectively. The median follow-up was 6.1 years, and 2169 (8%) patients died from BC. HRs for use, compared to no use, were estimated at 0.96 (95% CI 0.85–1.08) for low-dose aspirin (ER+: HR = 0.97, 95% CI 0.83–1.13; ER−: HR = 0.97, 95% CI 0.73–1.29, p value for interaction = 0.562), 0.84 (95% CI 0.75–0.94) for statins (ER+: HR = 0.95, 95% CI 0.82–1.09; ER−: HR = 0.77, 95% CI 0.60–1.00, p value for interaction = 0.259), and 0.70 (95% CI 0.51–0.96) for metformin (compared to use of non-metformin antidiabetics) (ER+: HR = 0.67, 95% CI 0.45–1.01; ER−: HR = 1.62, 95% CI 0.72–3.62, p value for interaction = 0.077). Conclusion We found evidence supporting an association between post-diagnostic use of statins and metformin and survival, in patients with BC. Our findings indicate potential differences according to ER status.

show abstract

“…BMI was determined by dividing the weight in kilograms by the square of the height in meters kg / m 2 . The World Health Organization (WHO) expert consultation used a BMI of 30 kg / m 2 as the threshold to identify obesity 28 , 29 . The self-reported diseases were categorized as follows: diabetes, hypertension, hypercholesterolemia, cardiovascular disease, and other diseases.…”

Section: Methodsmentioning

confidence: 99%

“…Diabetes diagnosis criteria include self-reported diabetes, medication or insulin use, HbAl > 6.5, and fasting glucose ⩾ 7.0 30 . If these people self-reported using antihypertensive drugs, they were diagnosed with hypertension; if they had a total cholesterol level of 6.2 mmol/L or more and were taking medication for it, they were diagnosed with hypercholesterolemia 29 . A self-reported medical history of coronary heart disease, myocardial infarction, angina, or stroke was considered cardiovascular disease (CVD) 31 , 32 .…”

Section: Methodsmentioning

confidence: 99%

Nonlinear associations between the ratio of family income to poverty and all-cause mortality among adults in NHANES study

Yi,

Li,

Dong

et al. 2024

Sci Rep

View full text Add to dashboard Cite

Socioeconomic status (SES) has been linked to mortality rates, with family income being a quantifiable marker of SES. However, the precise association between the family income-to-poverty ratio (PIR) and all-cause mortality in adults aged 40 and older remains unclear. A cross-sectional study was conducted using data from NHANES III, including 20,497 individuals. The PIR was used to assess financial status, and various demographic, lifestyle, and clinical factors were considered. Mortality data were collected from the NHANES III linked mortality file. The study revealed a non-linear association between PIR and all-cause mortality. The piecewise Cox proportional hazards regression model showed an inflection point at PIR 3.5. Below this threshold, the hazard ratio (HR) for all-cause mortality was 0.85 (95% CI 0.79–0.91), while above 3.5, the HR decreased to 0.66 (95% CI 0.57–0.76). Participants with lower income had a higher probability of all-cause mortality, with middle-income and high-income groups showing lower multivariate-adjusted HRs compared to the low-income group. This study provides evidence of a non-linear association between PIR and all-cause mortality in adults aged 40 and older, with an inflection point at PIR 3.5. These findings emphasize the importance of considering the non-linear relationship between family income and mortality when addressing socioeconomic health disparities.

show abstract

Low- or high-dose preventive aspirin use and risk of death from all-cause, cardiovascular disease, and cancer: A nationally representative cohort study

Cited by 9 publications

References 24 publications

Aspirin intervention before ICU admission reduced the mortality in critically ill patients with acute kidney injury: results from the MIMIC-IV

Aspirin intervention before ICU admission reduced the mortality in critically ill patients with acute kidney injury: results from the MIMIC-IV

Low-dose aspirin, statins, and metformin and survival in patients with breast cancers: a Norwegian population-based cohort study

Nonlinear associations between the ratio of family income to poverty and all-cause mortality among adults in NHANES study

Contact Info

Product

Resources

About