Effects of low-dose aspirin in subjects with dyslipidemia.
BACKGROUND
To evaluate the efficacy and safety of aspirin usage for coronary heart disease (CHD) primary prevention in patients with dyslipidemia.


METHODS
A cross-sectional study was conducted to enrolled subjects with documented dyslipidemia. A total of 202 patients with dyslipidemia were recruited and 138 were undergone aspirin treatment before this indexed admission and 64 had never been treated with aspirin. All subjects were undergone coronary angiography to diagnoses CHD. Clinical characteristics were collected and comparisons were performed between subjects with aspirin and subjects without aspirin therapy. Logistic regression analysis was conducted to assess the relation between aspirin and incident CHD and bleeding events.


RESULTS
Compared to those with aspirin therapy, CHD incidence was significantly higher in subjects without aspirin therapy (23.4 % versus 18.1 %, P < 0.05). Five patients in the aspirin group had gastrointestinal bleeding and no bleeding event was occurred in subjects without aspirin therapy. Subjects with aspirin therapy had higher rate of previous helicobacter pylori (HP) infection (8.7 % versus 4.7 %, P < 0.05). Compared to subjects without CHD, subjects with CHD were older, had higher frequencies of males and smokers, had higher heart rate, serum LDL cholesterol, Lp(a) and Hs-CRP levels. Percentages of subjects with hypertension, diabetes, gastrointestinal bleeding, and HP infection were also considerably higher in CHD group (P < 0.05 for all comparison). Logistic regression analysis revealed that aspirin was associated with reduced incidence of CHD, with odds ratio (OR) of 0.85 (95 % confidence interval (CI): 0.80-0.94, P < 0.05). Regarding safety endpoint, gastrointestinal bleeding risk associated with aspirin was attenuated to nonsignificant after adjusting for HP infection, with OR of 1.16 (95 % CI: 0.99-1.52, P = 0.178).


CONCLUSIONS
Aspirin is beneficial for reducing incident CHD, while modestly increases gastrointestinal bleeding risk. Screening subjects with previous HP infection may avoid aspirin-related gastrointestinal bleeding.
Department of Cardiology, Zhejiang Hospital, Zhejiang, China.
Guozhong
G
Lou
Department of Cardiology, Zhejiang Hospital, Zhejiang, China.
Jianming
J
Chen
Cardiovascular Center, Qingyuan Hospital of Traditional Chinese Medicine, Affiliated Hospital of Traditional Chinese Medicine University of Guangzhou, No.10, Qiaobei Road, Qingchen District, Qingyuan, Guangdong Province, 511000, China. qingyuanYuXia@tom.com.
Yu
Y
Xia
D000328:Adult; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D002097:C-Reactive Protein / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D003289:Convalescence; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000175:diagnosis*; D006339:Heart Rate; D016481:Helicobacter Infections / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D017270:Lipoprotein(a) / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D011322:Primary Prevention; D012307:Risk Factors; D012907:Smoking / Q000503:physiopathology
D008078:Cholesterol, LDL; D017270:Lipoprotein(a); D010975:Platelet Aggregation Inhibitors; D002097:C-Reactive Protein; D001241:Aspirin
Atherosclerotic cardiovascular diseases; Efficacy; Primary prevention; Safety