Aspirin reduces ischaemic events in patients with pneumonia

  • Hamilton F & al.
  • Eur Respir J
  • 17 Sep 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Aspirin use was associated with a reduced risk of ischaemic stroke and myocardial infarction (MI) in primary care patients who developed pneumonia.

Why this matters

  • Future research should focus on the potential use of aspirin in patients with newly diagnosed pneumonia, and whether the risk-benefit balance is shifted in the short-term in favour of aspirin prophylaxis.

Study design

  • This prior event rate ratio analysis with propensity score matching included 48,743 patients with pneumonia (age, >50 years) from the UK Clinical Practice Research Datalink (CPRD).
  • 9468 aspirin users were matched with 9468 non-aspirin users.
  • Primary outcome: combined outcome of ischaemic stroke and MI; secondary outcomes: ischaemic stroke and MI individually.
  • Funding: National Institute for Health Research.

Key results

  • Aspirin use was associated with a reduced risk of the combined primary outcome of ischaemic stroke and MI (adjusted HR [aHR], 0.64; 95% CI, 0.52-0.79) compared with no use.
  • For both secondary outcomes, aspirin use was associated with a reduced risk of:
    • ischaemic stroke (aHR, 0.70; 95% CI, 0.55-0.91); and
    • MI (aHR, 0.46; 95% CI, 0.30-0.72).
  • In Cox regression analysis, aspirin reduced the risk of the primary outcome (HR 0.84; 95% CI, 0.73–0.96) and stroke (HR, 0.80; 95% CI, 0.68-0.96), with weaker evidence of a reduction in MI (HR, 0.82; 95% CI, 0.66–1.02).

Limitations

  • Risk of confounding.