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Multicenter Study
. 2023 Sep 5;13(1):14646.
doi: 10.1038/s41598-023-41864-1.

Aspirin for primary prevention in patients with high cardiovascular risk: insights from CORE-Thailand registry

Wanwarang Wongcharoen  1 , Nichanan Osataphan  1 , Narawudt Prasertwitayakij  1 , Pannipa Suwannasom  1 , Swangjit Suraamornkul  2 , Wattana Wongtheptian  3 , Siriluck Gunaparn  1 , Wachiranun Sirikul  4 , Arintaya Phrommintikul  5   6
Affiliations
Multicenter Study

Aspirin for primary prevention in patients with high cardiovascular risk: insights from CORE-Thailand registry

Wanwarang Wongcharoen et al. Sci Rep. .

Abstract

Aspirin may be considered for primary prevention in non-elderly patients with high cardiovascular risk. However, contemporary management aimed at aggressive cardiovascular risk factor control may alter benefit-risk ratio of aspirin. Therefore, we aimed to examine the effect of aspirin for primary prevention on the long-term MACEs in a large cohort registry. Cohort Of patients with high Risk for cardiovascular Events (CORE-Thailand) registry is a prospective, multicenter, observational, longitudinal study of Thai patients with high atherosclerotic risk. Patients with established atherosclerotic cardiovascular diseases were excluded. Among 4259 patients with multiple cardiovascular risk factors, 1945 (45.7%) patients used aspirin. After propensity score matching, there were 3228 patients remained in post-matching analysis. During the median follow-up period of 58.2 months, we demonstrated that aspirin use increased risk of long-term MACEs in pre-matching cohort (unadjusted HR 1.76, 95% CI 1.43-2.17, P < 0.001) and post-matching cohort (HR 1.66 (1.31-2.10), P < 0.001). In addition, patients taking aspirin had a higher risk of bleeding than non-aspirin users in pre-matching cohort (unadjusted HR 2.28, 95% CI 1.09-4.75, P = 0.028). We demonstrated that aspirin was associated with increased risk of long-term MACEs in patients with multiple cardiovascular risk factors. Due to the non-randomized design, our results should be interpreted with caution.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Consort diagram.
Figure 2
Figure 2
Primary outcome of major cardiovascular events. (A) Full cohort, (B) Propensity score matching.
Figure 3
Figure 3
Bleeding events. (A) Full cohort, (B) Propensity score matching.
Figure 4
Figure 4
Subgroup analysis of primary outcome in the propensity score matching cohort.
See this image and copyright information in PMC

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