Prior aspirin use and outcomes in elderly patients hospitalized with acute myocardial infarction.
OBJECTIVE
We sought to assess the association between prior aspirin use and mortality, all-cause readmission, and condition-specific readmission at one month and six months in a national sample of Medicare beneficiaries hospitalized with a confirmed myocardial infarction (MI).


BACKGROUND
Prior aspirin use is considered a marker of higher risk in patients with MI, yet the prognostic significance of this factor has been debated.


METHODS
Medicare beneficiaries > or =65 years old hospitalized with MI were evaluated to determine whether there was an association between prior aspirin use and mortality (n = 118,992), all-cause readmission, and condition-specific readmission (n = 78,975) at one month and six months.


RESULTS
One-third of the patients (n = 39,531, 33.2%) were using aspirin before admission. Those with prior aspirin use had significantly lower mortality at one month (16.1% vs. 19.0%, p < 0.0001) and six months (24.7% vs. 27.5%, p < 0.0001). After multivariable adjustment, prior aspirin use was found to be associated with a lower risk of one-month (relative risk ratio 0.93, 95% confidence interval [CI] 0.90 to 0.96) and six-month mortality (hazard ratio 0.94, 95% CI 0.91 to 0.96). Prior aspirin use tended to reduce all-cause or coronary artery disease readmissions at one month or six months.


CONCLUSIONS
Prior aspirin use is not a marker of increased mortality in patients > or =65 years old hospitalized with MI.
Portnay
Edward L
EL
Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
Foody
JoAnne M
JM
Rathore
Saif S
SS
Wang
Yongfei
Y
Masoudi
Frederick A
FA
Curtis
Jeptha P
JP
Krumholz
Harlan M
HM
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality*; D010359:Patient Readmission / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome
D001241:Aspirin