Effect of aspirin on mortality in women with symptomatic or silent myocardial ischemia. Israeli BIP Study Group.
The benefit of aspirin therapy among women with coronary artery disease (CAD) is not well established. Previous studies have shown conflicting results among women. Data from 2,418 women with CAD screened for participation in the ongoing Bezafibrate Infarction Prevention (BIP) study were analyzed: 45% reported aspirin therapy. Baseline characteristics were similar in both groups. Cardiovascular mortality at 3.1 +/- 0.9 years of follow-up was 2.7% in the aspirin treated group versus 5.1% in the non-aspirin-treated women (p = 0.002). All cause mortality was 5.1% and 9.1%, respectively (p = 0.0001). Treatment with aspirin emerged as an independent predictor of reduced cardiovascular (RR = 0.61, 95% confidence interval [CI] 0.38 to 0.97) and all cause (RR = 0.66, 95% CI 0.47 to 0.93) mortality after multiple adjustment for possible confounders such as age, history of myocardial infarction, systemic hypertension, diabetes mellitus, peripheral vascular disease, current smoking, New York Heart Association classification, and concomitant treatment with digitalis. Women who benefited the most from aspirin therapy were older, diabetic, symptomatic, or had a previous myocardial infarction. Thus, treatment with aspirin was associated with reduced mortality among women with CAD. This study suggests that women with CAD should be treated with aspirin, unless specific contraindications exist.
Harpaz
D
D
Heart Institute, E. Wolfson Medical Center, Holon, Israel.
Benderly
M
M
Goldbourt
U
U
Kishon
Y
Y
Behar
S
S
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003327:Coronary Disease / Q000188:drug therapy*; D004071:Digitalis Glycosides / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000401:mortality* / Q000517:prevention & control*; D016016:Proportional Hazards Models; D012307:Risk Factors; D015996:Survival Rate
D004071:Digitalis Glycosides; D001241:Aspirin