PCV9 A 5-YEAR REAL WORLD PATIENT LEVEL ANALYSIS OF LOW-DOSE ASPIRIN PRIMARY PREVENTION BENEFIT AND RISK ANALYSIS BASED ON A MULTI-HOSPITAL EMR DATABASE

Abstract

Recently, there are conflicting publications on the primary prevention benefits and risks of low dose aspirin therapy. The objective of this study was to evaluate the benefits and risks of low-dose aspirin (75-100mg/d) therapy in high-risk population based on a real world Electronic Medical Record (EMR) database. A retrospective database study research was conducted including individuals age ≥50 years-old and with the history of hypertension, and diabetes between 2000.01.01 to 2018.08.10 in Suvalue EMR Database. Study population was divided into two groups taking aspirin vs. not taking aspirin. And patients with prior cardiovascular and bleeding events were excluded. Our main outcomes were the occurrence of first serious vascular events (i.e., myocardial infarction, stroke or transient ischemic attack) and the first major bleeding events (i.e., intracranial haemorrhage or gastrointestinal bleeding) in 5-year follow-up period. To minimize confounding, aspirin group were matched based on nearest neighbour propensity score in a 1:1 ratio to non-aspirin group. A total of 2592 matched pair individuals were included in the study. The patient’s characteristics were well comparable between two study groups. We observed that the 5-year cumulative rate of serious vascular events was significantly lower in the aspirin group than in the non-aspirin group (3.8% vs. 9.7%; hazard ratio:0.34; P<0.001). Stroke occurred in 44 (3.4%) patients in the aspirin group versus 110 (8.5%) in the non-aspirin group (P<0·05). No statistically significant difference was found in the incidence of myocardial infarction and transient ischemic attack. On the risk side, no statistically significant difference was found in the incidence of major bleeding events between two groups (1.0% vs.1.0%; P=0.700). As primary prophylaxis, aspirin low dose therapy reduced the risks of incidence of serious vascular events and did not result in additional major bleeding events in individuals age ≥50 with the comorbidity of hypertension, diabetes.