Older patients do not benefit from aspirin for CVD prevention
Taking aspirin for primary prevention of cardiovascular disease does not benefit older adults, according to findings from the ASPREE trial presented at the European Society of Cardiology Congress.
Christopher M. Reid, professor of clinical epidemiology at Monash University in Melbourne, Australia, and colleagues assessed whether the baseline CVD risk of patients in the ASPREE trial could change aspirin’s effects on CV events, disability-free survival and major bleeding.
They used the Framingham Modified Risk Equation to assess participants aged 65 to 74 years (n = 10,918) and the American College of Cardiology/American Heart Association Atherosclerotic CVD Pooled Risk Equation for participants aged up to 79 years (n = 15,825). Multiple CVD risk factors were used to assess baseline risk for those aged 80 years and older.
Among patients in the lowest CVD risk tertile, aspirin was tied to a significantly increased risk for major bleeding in both patients aged 65 to 74 years(HR = 2.6; 95% CI, 1.51-4.48) and in those aged up to 79 years (HR = 2.3; 95% CI, 1.48-3.58).
In both groups, those with the highest CVD risk given aspirin had fewer CVD events than those given placebo. Researchers identified an increased risk for major bleeding for the highest CVD risk tertile in those aged up to 79 years (HR = 1.31; 95% CI, 0.99-1.74).
For adults aged 80 years and older, aspirin was associated with higher rates of bleeding at all levels of CVD risk.
Aspirin did not have a statistically significant effect on disability, dementia or death in any group.
“As a population strategy, findings do not support aspirin for primary prevention in the elderly as the risks outweighed the benefits,” Reid said during a presentation.
Reid CM. Late-breaking science in cardiovascular pharmacology. Presented at: European Society of Cardiology Congress; Aug. 31 to Sept. 4, 2019; Paris.
Disclosure: Reid reports no relevant financial disclosures.