Reduction of coronary events with aspirin in older patients with prior myocardial infarction treated with and without statins.
In an observational prospective study of 1,410 patients (mean age, 81 +/- 9 years) with prior myocardial infarction, no contraindications to aspirin, and a serum low-density lipoprotein cholesterol level of 125 mg/dL or higher, 832 (59%) were treated with aspirin. At the 36-month follow-up evaluation, the incidence of new coronary events was 52% in persons treated with aspirin versus 70% in those who were not treated with aspirin (P < 0.0001). The stepwise Cox regression model showed that significant independent predictors of new coronary events were age (risk ratio, 1.05 for each 1-year increase), current cigarette smoking (risk ratio, 2.7), hypertension (risk ratio, 1.7), diabetes mellitus (risk ratio, 2.2), initial serum low-density lipoprotein cholesterol level (risk ratio, 1.01 for each 1-mg/dL increase), initial serum high-density lipoprotein cholesterol level (risk ratio, 0.96 for each 1-mg/dL increase), use of statins (risk ratio, 0.46), and use of aspirin (risk ratio, 0.48).
Aronow
Wilbert S
WS
Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, USA. WSAronow@aol.com
Ahn
Chul
C
D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use*; D015331:Cohort Studies; D016001:Confidence Intervals; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000188:drug therapy*; D011336:Probability; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D055502:Secondary Prevention; D012720:Severity of Illness Index; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin