UNASSIGNED: The Low-dose Aspirin for Primary and Secondary Prevention of Cardiovascular Disease in the Elderly Study (LAPIS) is a multicenter, prospective, observational cohort study, this study was a single-center interim analysis of LAPIS. Patients aged ≥60 and required long-term aspirin for primary and secondary prevention of CVD were eligible. From Apr 1, 2019 to Feb 28, 2022, 165 patients who received 50 mg/d aspirin and 261 patients who received 100 mg/d aspirin were included in the study. The incidence of major cardiovascular events (MACEs), bleeding events, and gastrointestinal adverse events were compared between two groups.
UNASSIGNED: After adjusting for patient characteristics using propensity score matching, aspirin 100 mg/d was associated with increased incidence rates of total bleeding events (28.34 vs.17.25 events/100 patient-years, HR 1.671, 95% CI 1.024-2.712, P = 0.040) and minor bleeding events (27.63 vs.15.92 events/100 patient-years, HR 1.738, 95% CI 1.056-2.861, P = 0.031), whereas the incidence of MACE (6.35 vs 6.65 events/100 patient-years, HR 0.921, 95% CI 0.399-2.127, P = 0.848) and gastrointestinal adverse events (12.73 vs.10.42 events/100 patient-years, HR 1.206, 95% CI 0.623-2.337, P = 0.578) were similar between the two groups. Multivariate Cox analysis identified that aspirin dose (100 mg/d vs. 50 mg/d, HR 1.918, 95% CI 1.137-3.235, P = 0.015), concomitant use of other antiplatelets (HR 1.748, 95% CI 1.009-3.028, P = 0.046) and anticoagulants (HR 2.501, 95% CI 1.287-4.862, P = 0.007) were independently associated with bleeding events.
UNASSIGNED: 50 mg/d aspirin may be preferred to balance the safety and effectiveness in Chinese individuals over 60 years of age who need long-term aspirin for the prevention and management of CVD.
UNASSIGNED: ChiCTR1900021980 (chictr.org.cn). Registered on 19 March 2019.
UNASSIGNED:低剂量阿司匹林用于老年人心血管疾病一级和二级预防的研究(LAPIS)是一个多中心,prospective,观察性队列研究,本研究为LAPIS单中心中期分析.年龄≥60岁且需要长期服用阿司匹林进行CVD一级和二级预防的患者符合资格。从2019年4月1日至2022年2月28日,165名接受50mg/d阿司匹林的患者和261名接受100mg/d阿司匹林的患者被纳入研究。主要心血管事件(MACEs)的发生率,出血事件,比较两组胃肠道不良事件发生情况。
未经评估:使用倾向评分匹配调整患者特征后,阿司匹林100mg/d与总出血事件发生率增加相关(28.34vs.17.25事件/100患者年,HR1.671,95%CI1.024-2.712,P=0.040)和轻微出血事件(27.63vs.15.92事件/100患者年,HR1.738,95%CI1.056-2.861,P=0.031),而MACE的发生率(6.35vs6.65事件/100患者年,HR0.921,95%CI0.399-2.127,P=0.848)和胃肠道不良事件(12.73vs.10.42事件/100患者年,两组HR1.206,95%CI0.623-2.337,P=0.578)相似。多变量Cox分析确定阿司匹林剂量(100mg/d与50mg/d,HR1.918,95%CI1.137-3.235,P=0.015),同时使用其他抗血小板(HR1.748,95%CI1.009-3.028,P=0.046)和抗凝剂(HR2.501,95%CI1.287-4.862,P=0.007)与出血事件独立相关.
UNASSIGNED:在60岁以上需要长期服用阿司匹林预防和治疗心血管疾病的中国人群中,为了平衡安全性和有效性,可能首选50mg/d阿司匹林。
未经批准:ChiCTR1900021980(chictr.org.cn)。2019年3月19日注册。