Abstract
BackgroundTo evaluate the efficacy and safety of aspirin usage for coronary heart disease (CHD) primary prevention in patients with dyslipidemia.MethodsA cross-sectional study was conducted to enrolled subjects with documented dyslipidemia. A total of 202 patients with dyslipidemia were recruited and 138 were undergone aspirin treatment before this indexed admission and 64 had never been treated with aspirin. All subjects were undergone coronary angiography to diagnoses CHD. Clinical characteristics were collected and comparisons were performed between subjects with aspirin and subjects without aspirin therapy. Logistic regression analysis was conducted to assess the relation between aspirin and incident CHD and bleeding events.ResultsCompared to those with aspirin therapy, CHD incidence was significantly higher in subjects without aspirin therapy (23.4 % versus 18.1 %, P < 0.05). Five patients in the aspirin group had gastrointestinal bleeding and no bleeding event was occurred in subjects without aspirin therapy. Subjects with aspirin therapy had higher rate of previous helicobacter pylori (HP) infection (8.7 % versus 4.7 %, P < 0.05). Compared to subjects without CHD, subjects with CHD were older, had higher frequencies of males and smokers, had higher heart rate, serum LDL cholesterol, Lp(a) and Hs-CRP levels. Percentages of subjects with hypertension, diabetes, gastrointestinal bleeding, and HP infection were also considerably higher in CHD group (P < 0.05 for all comparison). Logistic regression analysis revealed that aspirin was associated with reduced incidence of CHD, with odds ratio (OR) of 0.85 (95 % confidence interval (CI): 0.80-0.94, P < 0.05). Regarding safety endpoint, gastrointestinal bleeding risk associated with aspirin was attenuated to nonsignificant after adjusting for HP infection, with OR of 1.16 (95 % CI: 0.99-1.52, P = 0.178).ConclusionAspirin is beneficial for reducing incident CHD, while modestly increases gastrointestinal bleeding risk. Screening subjects with previous HP infection may avoid aspirin-related gastrointestinal bleeding.
Highlights
To evaluate the efficacy and safety of aspirin usage for coronary heart disease (CHD) primary prevention in patients with dyslipidemia
Dyslipidemia is a major risk factor of atherosclerotic cardiovascular diseases (ASCVD) [9], and increased serum level of low density lipoprotein (LDL) cholesterol is associated with higher incidence and prevalence of coronary heart disease (CHD) and ischemic stroke [10, 11]
Proportions of subjects with hypertension (26.1 % versus 28.1 %) and diabetes (13.8 % versus 15.6 %) were comparable. Compared to those with aspirin therapy, CHD incidence was significantly higher in subjects without aspirin therapy (23.4 % versus 18.1 %, P < 0.05)
Summary
To evaluate the efficacy and safety of aspirin usage for coronary heart disease (CHD) primary prevention in patients with dyslipidemia. It is clinically relevant and important to Dyslipidemia is a major risk factor of ASCVD [9], and increased serum level of low density lipoprotein (LDL) cholesterol is associated with higher incidence and prevalence of coronary heart disease (CHD) and ischemic stroke [10, 11]. Statins has been broadly used for lowering serum LDL cholesterol level, which in turn reduces cardiovascular events [10, 12, 13]. Whether aspirin could decrease cardiovascular risk in subjects with dyslipidemia is uncertain, and the data on the efficacy of low-dose, enteric-coated and once-daily aspirin on ASCVD primary prevention in Chinese population is limited.
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