Lauren H Theilen1, Philip Greenland2, Jasmina Varagic3, Janet Catov4, Anthony Shanks5, Vanessa Thorsten6, Corette B Parker7, Rebecca McNeil8, Brian Mercer9, Matthew Hoffman10, Ronald Wapner11, David Haas12, Hyagriv Simhan13, William Grobman14, Judith H Chung15, Lisa D Levine16, Shannon Barnes17, Noel Bairey Merz18, George Saade19, Robert M Silver20. 1. University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132, United States. Electronic address: lauren.theilen@hsc.utah.edu. 2. Northwestern University Feinberg School of Medicine, 680 N Lakeshore Dr, Chicago, IL 60611, United States. Electronic address: p-greenland@northwestern.edu. 3. National Heart, Lung, and Blood Institute, 31 Center Drive, Bethesda, MD 20892, United States. Electronic address: jasmina.varagic@nih.gov. 4. University of Pittsburgh, 300 Halket Street, Pittsburgh, PA 15213, United States. Electronic address: catovjm@upmc.edu. 5. Indiana University School of Medicine, 720 Eskenazi Avenue, Indianapolis, IN 46202, United States. Electronic address: ashanks@iupui.edu. 6. RTI International, United States. Electronic address: vthorsten@rti.org. 7. RTI International, United States. Electronic address: rette@rti.org. 8. RTI International, United States. Electronic address: rmcneil@rti.org. 9. MetroHealth, 2500 MetroHealth Drive, G267, Cleveland, OH 44109, United States. Electronic address: bmercer@metrohealth.org. 10. Christiana Care, 4755 Ogletown Stanton Road, Newark, DE 19718, United States. Electronic address: mhoffman@christianacare.org. 11. Columbia University, 622 West 168(th) Street, New York, NY 10032, United States. Electronic address: rw2191@cumc.columbia.edu. 12. Indiana University School of Medicine, 720 Eskenazi Avenue, Indianapolis, IN 46202, United States. Electronic address: dahaas@iu.edu. 13. University of Pittsburgh, 300 Halket Street, Pittsburgh, PA 15213, United States. Electronic address: hsimhan@upmc.edu. 14. Northwestern University Feinberg School of Medicine, 680 N Lakeshore Dr, Chicago, IL 60611, United States. Electronic address: w-grobman@northwestern.edu. 15. University of California, Irvine, 333 City Tower West, Suite 1400, Orange, CA 92868, United States. Electronic address: judithc@hs.uci.edu. 16. University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, 2 Silverstein, Philadelphia, PA 19104, United States. Electronic address: lisa.levine@pennmedicine.upenn.edu. 17. Indiana University School of Medicine, 720 Eskenazi Avenue, Indianapolis, IN 46202, United States. Electronic address: shanbarn@iupui.edu. 18. Cedars Sinai Smidt Heart Institute, 127 S San Vicente Blvd #A3600, Los Angeles, CA 90048, United States. Electronic address: noel.baireymerz@cshs.org. 19. University of Texas Medical Branch, 1005 Harborside Drive, Galveston, TX 77555, United States. Electronic address: gsaade@utmb.edu. 20. University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132, United States. Electronic address: bob.silver@hsc.utah.edu.
Abstract
OBJECTIVES: To evaluate the association between aspirin use during first pregnancy and later maternal cardiovascular risk. STUDY DESIGN: In this secondary analysis of a prospective cohort, we included participants who carried their first pregnancy to 20 + weeks, had data regarding aspirin use, and attended a study visit 2-7 years following delivery. The exposure was aspirin use during the first pregnancy. We calculated aspirin use propensity scores from logistic regression models including baseline variables associated with aspirin use in pregnancy and cardiovascular risk. Outcomes of interest were incident cardiovascular-related diagnoses 2-7 years following delivery. Robust Poisson regression calculated the risk of outcomes by aspirin exposure, adjusting for the aspirin use propensity score. MAIN OUTCOME MEASURES: The primary outcome was a composite of incident cardiovascular diagnoses at the time of the study visit: cardiovascular events, chronic hypertension, metabolic syndrome, prediabetes or type 2 diabetes, dyslipidemia, and chronic kidney disease. RESULTS: Of 4,480 women included, 84 (1.9%) reported taking aspirin during their first pregnancy. 52.6% of participants in the aspirin-exposed group and 43.0% in the unexposed group had the primary outcome. After adjusting for the aspirin use propensity scores, aspirin use during the first pregnancy was not associated with any of the outcomes. CONCLUSION: We did not detect an association between aspirin use during the first pregnancy and cardiovascular-related diagnoses 2-7 years later. Our study was only powered to detect a large difference in relative risk, so we cannot rule out a smaller difference that may be clinically meaningful.
OBJECTIVES: To evaluate the association between aspirin use during first pregnancy and later maternal cardiovascular risk. STUDY DESIGN: In this secondary analysis of a prospective cohort, we included participants who carried their first pregnancy to 20 + weeks, had data regarding aspirin use, and attended a study visit 2-7 years following delivery. The exposure was aspirin use during the first pregnancy. We calculated aspirin use propensity scores from logistic regression models including baseline variables associated with aspirin use in pregnancy and cardiovascular risk. Outcomes of interest were incident cardiovascular-related diagnoses 2-7 years following delivery. Robust Poisson regression calculated the risk of outcomes by aspirin exposure, adjusting for the aspirin use propensity score. MAIN OUTCOME MEASURES: The primary outcome was a composite of incident cardiovascular diagnoses at the time of the study visit: cardiovascular events, chronic hypertension, metabolic syndrome, prediabetes or type 2 diabetes, dyslipidemia, and chronic kidney disease. RESULTS: Of 4,480 women included, 84 (1.9%) reported taking aspirin during their first pregnancy. 52.6% of participants in the aspirin-exposed group and 43.0% in the unexposed group had the primary outcome. After adjusting for the aspirin use propensity scores, aspirin use during the first pregnancy was not associated with any of the outcomes. CONCLUSION: We did not detect an association between aspirin use during the first pregnancy and cardiovascular-related diagnoses 2-7 years later. Our study was only powered to detect a large difference in relative risk, so we cannot rule out a smaller difference that may be clinically meaningful.
Authors: Mary Downes Gastrich; Stavros Zinonos; Gloria Bachmann; Nora M Cosgrove; Javier Cabrera; Jerry Q Cheng; John B Kostis Journal: J Womens Health (Larchmt) Date: 2019-08-16 Impact factor: 2.681
Authors: Daniel L Rolnik; David Wright; Liona C Poon; Neil O'Gorman; Argyro Syngelaki; Catalina de Paco Matallana; Ranjit Akolekar; Simona Cicero; Deepa Janga; Mandeep Singh; Francisca S Molina; Nicola Persico; Jacques C Jani; Walter Plasencia; George Papaioannou; Kinneret Tenenbaum-Gavish; Hamutal Meiri; Sveinbjorn Gizurarson; Kate Maclagan; Kypros H Nicolaides Journal: N Engl J Med Date: 2017-06-28 Impact factor: 91.245
Authors: Aneesha Thobani; Devinder S Dhindsa; Benjamin D DeMoss; Mohamad Raad; Pratik B Sandesara; Laurence S Sperling; Jefferson T Baer Journal: Am J Cardiol Date: 2019-09-09 Impact factor: 2.778
Authors: Pensée Wu; Randula Haththotuwa; Chun Shing Kwok; Aswin Babu; Rafail A Kotronias; Claire Rushton; Azfar Zaman; Anthony A Fryer; Umesh Kadam; Carolyn A Chew-Graham; Mamas A Mamas Journal: Circ Cardiovasc Qual Outcomes Date: 2017-02-22