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Early aspirin initiation following heart transplantation is associated with reduced risk of allograft vasculopathy during long‐term follow‐up
Author(s) -
Peled Yael,
Lavee Jacob,
Raichlin Eugenia,
Katz Moshe,
Arad Michael,
Kassif Yigal,
Peled Amir,
Asher Elad,
Elian Dan,
HarZahav Yedael,
Shlomo Nir,
Freimark Dov,
Goldenberg Ilan,
Klempfner Robert
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13133
Subject(s) - medicine , aspirin , proportional hazards model , risk factor , cardiology , heart transplantation , transplantation , surgery , gastroenterology
Aim Cardiac allograft vasculopathy ( CAV ) is a major cause of morbidity and mortality after heart transplantation ( HT ). Enhanced platelet reactivity is a contributing factor. We aimed to investigate the association between early initiation of aspirin therapy post‐ HT and the 15‐year risk of the development of CAV . Methods We studied 206 patients who underwent HT between 1991 and 2016. Multivariate Cox proportional hazards regression modeling was employed to evaluate the association between early aspirin initiation and the long‐term risk of CAV . Results Ninety‐seven patients (47%) received aspirin therapy. At 15 years of follow‐up, the rate of CAV was lowered by sixfold in patients treated with aspirin compared with the non‐treated patients: 7% vs 37% (log‐rank P ‐value<.001). The corresponding rates of the combined end‐point of CAV or death were also lower in patients treated with aspirin, compared with the non‐treated patients: 42% vs 78% (log‐rank P < .001). Consistently, multivariate analysis showed that early aspirin therapy was associated with a significant 84% ( P < .001) reduction in CAV risk, and with a corresponding 68% ( P < .0001) reduction in the risk of the combined end‐point of CAV or death. We further validated these results using a propensity score‐adjusted Cox model. Conclusions Early aspirin initiation is independently associated with a significant reduction in the risk of CAV .