I-Chen Wu1,2, Hui-Min Hsieh3, Fang-Jung Yu1,2, Meng-Chieh Wu1, Tzung-Shiun Wu1, Ming-Tsang Wu3,4,5. 1. Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 2. Faculty of Medicine, Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 3. Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan. 4. Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 5. Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Abstract
BACKGROUND: The long-term risk-benefit effect of occasional and regular use of low-dose aspirin (≤ 100 mg per day) in primary prevention of vascular diseases and cancers was calculated. METHODS: One representative database of 1 000 000 participants from Taiwan's National Health Insurance scheme in 1997-2000 was used. The potential study subjects were those aged 30-95 years, were found not to have been prescribed aspirin before 1 January 2000, but to have first been prescribed low-dose aspirin (≤ 100 mg per day) after that date and were followed up to 31 December 2009. Participants prescribed low-dose aspirin < 20% during the study period were considered occasional users and those prescribed ≥ 80% regular users. After the propensity score matching, rate differences of haemorrhage, ischaemia and cancer between these users were calculated their net clinical risk. RESULTS: A total of 1720 pairs were analysed. During the study period, haemorrhage and ischaemia occurred in 25 (1·45%) and 67 participants (3·90%) in occasional users and 69 (4·01%) and 100 participants (5·81%) in regular users, whereas cancer occurred in 32 participants (1·86%) in occasional users and 26 participants (1·51%) in regular users. The crude and adjusted net clinical risks of low-dose aspirin use between the two frequency of users (≥ 80% vs. < 20%) were 4·12% (95% CI = 2·19%, 6·07%; P < 0·001) and 3·93% (95% CI = 2·01%, 5·84%; P < 0·001). CONCLUSIONS: A long-term regular use of low-dose aspirin might not be better than occasional use in the primary prevention against major vascular diseases and cancer.
BACKGROUND: The long-term risk-benefit effect of occasional and regular use of low-dose aspirin (≤ 100 mg per day) in primary prevention of vascular diseases and cancers was calculated. METHODS: One representative database of 1 000 000 participants from Taiwan's National Health Insurance scheme in 1997-2000 was used. The potential study subjects were those aged 30-95 years, were found not to have been prescribed aspirin before 1 January 2000, but to have first been prescribed low-dose aspirin (≤ 100 mg per day) after that date and were followed up to 31 December 2009. Participants prescribed low-dose aspirin < 20% during the study period were considered occasional users and those prescribed ≥ 80% regular users. After the propensity score matching, rate differences of haemorrhage, ischaemia and cancer between these users were calculated their net clinical risk. RESULTS: A total of 1720 pairs were analysed. During the study period, haemorrhage and ischaemia occurred in 25 (1·45%) and 67 participants (3·90%) in occasional users and 69 (4·01%) and 100 participants (5·81%) in regular users, whereas cancer occurred in 32 participants (1·86%) in occasional users and 26 participants (1·51%) in regular users. The crude and adjusted net clinical risks of low-dose aspirin use between the two frequency of users (≥ 80% vs. < 20%) were 4·12% (95% CI = 2·19%, 6·07%; P < 0·001) and 3·93% (95% CI = 2·01%, 5·84%; P < 0·001). CONCLUSIONS: A long-term regular use of low-dose aspirin might not be better than occasional use in the primary prevention against major vascular diseases and cancer.
Authors: Christian Schoergenhofer; Eva-Luise Hobl; Michael Schwameis; Georg Gelbenegger; Thomas Staudinger; Gottfried Heinz; Walter S Speidl; Christian Zauner; Birgit Reiter; Irene Lang; Bernd Jilma Journal: Eur J Clin Invest Date: 2017-06-20 Impact factor: 4.686