Aspirin and the treatment of heart failure in the elderly.
OBJECTIVE
We sought (1) to determine how often aspirin is prescribed as a discharge medication among patients 65 years or older and hospitalized with both heart failure and coronary artery disease; (2) to identify patient characteristics associated with the decision to prescribe aspirin; and (3) to evaluate the association between aspirin prescription at discharge and 1-year survival.


METHODS
We performed a retrospective cohort study of consecutive Medicare beneficiary survivors of a hospitalization for heart failure at 18 Connecticut hospitals (up to 200 hospitalizations per hospital) from 1994 to 1995.


RESULTS
Among the 1110 patients in the study sample who did not have a contraindication to aspirin, aspirin therapy was prescribed for 456 (41%) at discharge. Patients who were prescribed aspirin at discharge had a lower 1-year mortality after discharge than patients who were not prescribed aspirin (odds ratio, 0.71; 95% confidence interval, 0.54-0.94), even after adjustment for baseline differences in demographic, clinical, and treatment characteristics between the 2 groups.


CONCLUSIONS
This study has identified a strong association between the use of aspirin and lower mortality in older patients with both heart failure and coronary artery disease. The benefit of aspirin is consistent with that expected from randomized trials of other groups of patients with vascular disease.
Yale University School of Medicine, 333 Cedar St, PO Box 208025, New Haven, CT 06520-8025, USA. harlan.krumholz@yale.edu
H M
HM
Krumholz
Y T
YT
Chen
M J
MJ
Radford
D000367:Age Factors; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D015331:Cohort Studies; D003237:Connecticut / Q000453:epidemiology; D003327:Coronary Disease / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D016019:Survival Analysis
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin