Aspirin use associated with 26% increased HF risk in patients with predisposing factors
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Among patients with predisposing factors for HF, aspirin use was associated with a 26% increased risk for HF development, researchers reported in ESC Heart Failure.
“This is the first study to report that among individuals with at least one risk factor for heart failure, those taking aspirin were more likely to subsequently develop the condition than those not using the medication,” Blerim Mujaj, MD, from the Studies Coordination Centre at the Research Unit Hypertension and Cardiovascular Epidemiology in the KU Leuven department of cardiovascular sciences at the University of Leuven, Belgium, and the University of Freiburg, Germany, said in a press release. “While the findings require confirmation, they do indicate that the potential link between aspirin and heart failure needs to be clarified.”
The analysis evaluated 30,827 patients (mean age, 67 years; 34% women) at risk for HF development who were enrolled into the HOMAGE study, a prospective, randomized, open-label, masked multicenter trial. At-risk patients were defined as one or more of the following: smokers, individuals with obesity, those with high BP, those with high cholesterol, those with diabetes and those with CVD. Researchers collected risk factors for CVD and aspirin use at baseline.
There were 1,330 patients who experienced a HF event over 5.3 years. Aspirin use was independently associated with a 26% increased risk for new HF (adjusted HR = 1.26; 95% CI, 1.12-1.41; P < .001). This association remained in the propensity score matching analysis of patients who used aspirin and those who did not (HR = 1.26; 95% CI, 1.1-1.44; P < . 001).
To verify these results, researchers evaluated 22,690 patients (73.6% of the total cohort) without CVD history and observed an increased risk of 27% for HF development (HR = 1.27; 95% CI, 1.1-1.46; P = .001).
According to the researchers, current guideline recommendations show uncertainty in aspirin use and continues to be controversial in primary prevention. Because of this, the researchers noted, the current study demonstrates the need for more verification on the CV benefits associated with aspirin use on HF events.
“Large multinational randomized trials in adults at risk for heart failure are needed to verify these results,” Mujaj said. “Until then, our observations suggest that aspirin should be prescribed with caution in those with heart failure or with risk factors for the condition.”
Reference:
- Aspirin is linked with increased risk of heart failure. https://www.escardio.org/The-ESC/Press-Office/Press-releases/Aspirin-is-linked-with-increased-risk-of-heart-failure. Published Nov. 23, 2021. Accessed Nov. 22, 2021.
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