title: Does aspirin use prevent acute coronary syndrome in patients with pneumonia: multicenter prospective randomized trial.
abstract: OBJECTIVE
  The aim of this study was to test the hypothesis that aspirin would reduce the risk for acute coronary syndromes (ACSs) in patients with pneumonia.
  
  
  BACKGROUND
  Pooled data suggest that pneumonia may trigger an ACS as a result of inflammatory reactions and the prothrombotic changes in patients with pneumonia. Hypothetically considering its antiaggregating and anti-inflammatory effects, aspirin might also be beneficial for the primary prevention of ACS in patients with pneumonia.
  
  
  METHODS
  One hundred and eighty-five patients with pneumonia who had more than one risk factor for cardiovascular disease were randomized to an aspirin group (n=91) or a control group (n=94). The patients in the aspirin group received 300 mg of aspirin daily for 1 month. ECGs were recorded on admission and 48 h and 30 days after admission to assess silent ischemia. The level of high-sensitivity cardiac troponin T was measured on admission and 48 h after admission. The primary endpoint was the development of ACS within 1 month. The secondary endpoints included cardiovascular death and death from any cause within 1 month.
  
  
  RESULTS
  The χ-test showed that the rates of ACS at 1 month were 1.1% (n=1) in the aspirin group and 10.6% (n=10) in the control group (relative risk, 0.103; 95% confidence interval 0.005-0.746; P=0.015). Aspirin therapy was associated with a 9% absolute reduction in the risk for ACS. There was no significant decrease in the risk of death from any cause (P=0.151), but the aspirin group had a decreased risk of cardiovascular death (risk reduction: 0.04, P=0.044).
  
  
  CONCLUSIONS
  This randomized open-label study shows that acetyl salicylic acid is beneficial in the reduction of ACS and cardiovascular mortality among patients with pneumonia.
authors.affiliation: Department of Cardiology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey. fahrettin_oz@hotmail.com
authors.forename: Fahrettin
authors.initials: F
authors.lastname: Oz
authors.forename: Sule
authors.initials: S
authors.lastname: Gul
authors.forename: Mehmet G
authors.initials: MG
authors.lastname: Kaya
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yazici
authors.forename: Ismet
authors.initials: I
authors.lastname: Bulut
authors.forename: Ali
authors.initials: A
authors.lastname: Elitok
authors.forename: Gunay
authors.initials: G
authors.lastname: Ersin
authors.forename: Ozlem
authors.initials: O
authors.lastname: Abakay
authors.forename: Cayan D
authors.initials: CD
authors.lastname: Akkoyun
authors.forename: Aytac
authors.initials: A
authors.lastname: Oncul
authors.forename: Erdogan
authors.initials: E
authors.lastname: Cetinkaya
authors.forename: Michael C
authors.initials: MC
authors.lastname: Gibson
authors.forename: Huseyin
authors.initials: H
authors.lastname: Oflaz
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011014:Pneumonia / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D011322:Primary Prevention / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood; D014421:Turkey
chemical_list: D015415:Biomarkers; D002317:Cardiovascular Agents; D020107:Troponin T; D001241:Aspirin