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A long‐term risk‐benefit analysis of low‐dose aspirin in primary prevention
Author(s) -
Wu IChen,
Hsieh HuiMin,
Yu FangJung,
Wu MengChieh,
Wu TzungShiun,
Wu MingTsang
Publication year - 2016
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12575
Subject(s) - aspirin , medicine , low dose aspirin , primary prevention , propensity score matching , disease
Background The long‐term risk‐benefit effect of occasional and regular use of low‐dose aspirin (≤ 100 mg per day) in primary prevention of vascular diseases and cancers was calculated. Methods One representative database of 1 000 000 participants from Taiwan's National Health Insurance scheme in 1997–2000 was used. The potential study subjects were those aged 30–95 years, were found not to have been prescribed aspirin before 1 January 2000, but to have first been prescribed low‐dose aspirin (≤ 100 mg per day) after that date and were followed up to 31 December 2009. Participants prescribed low‐dose aspirin < 20% during the study period were considered occasional users and those prescribed ≥ 80% regular users. After the propensity score matching, rate differences of haemorrhage, ischaemia and cancer between these users were calculated their net clinical risk. Results A total of 1720 pairs were analysed. During the study period, haemorrhage and ischaemia occurred in 25 (1·45%) and 67 participants (3·90%) in occasional users and 69 (4·01%) and 100 participants (5·81%) in regular users, whereas cancer occurred in 32 participants (1·86%) in occasional users and 26 participants (1·51%) in regular users. The crude and adjusted net clinical risks of low‐dose aspirin use between the two frequency of users (≥ 80% vs. < 20%) were 4·12% (95% CI = 2·19%, 6·07%; P < 0·001) and 3·93% (95% CI = 2·01%, 5·84%; P < 0·001). Conclusions A long‐term regular use of low‐dose aspirin might not be better than occasional use in the primary prevention against major vascular diseases and cancer.