Failure of aspirin to prevent myocardial infarction and adverse outcome during follow-up—a large series of all-comers

Figures & data

Table

AA	arachidonic acid
ACS	acute coronary syndrome
CABG	coronary artery by-pass surgery
CAD	coronary artery disease
CCS	Canadian Cardiac Society
COX	cyclo-oxygenase
ECG	electrocardiogram
GPIIb/IIIa	glycoprotein IIb/IIIa
GPVI	glycoprotein VI
LMWH	low-molecular weight heparin
NSAID	nonsteroidal anti-inflammatory drug
NSTEMI	non-ST-elevation myocardial infarction
NYHA	New York Heart Association
OR	odds ratio
PCI	percutaneous coronary intervention
STEMI	ST-elevation myocardial infarction
UA	unstable angina pectoris

Table I.  Characteristics of the study population at admission.

Age (years)	71.6 (SD 14.8)
Male	57.6% (575/998)
Hypertension	54.4% (543/998)
Diabetes	26.4% (263/998)
Current smoking	17.7% (177/998)
Prior myocardial infarction	24.5% (244/998)
Prior revascularization	10.8% (108/998)

Table II.  Medications at admission.

Aspirin	42.4% (423/998)
Warfarin	10.9% (109/998)
Clopidogrel	0.7% (7/998)
Beta-blockers	47.4% (473/998)
Nitrates	45.1% (450/998)
CCB	20.8% (208/998)
Digoxin	12.1% (121/998)
ACEi or ARB	28.3% (282/998)
Diuretics	34.1% (340/998)
Statins	19.0% (190/998)

CCB = calcium channel blockers; ACEi = angiotensin converting enzyme inhibitors; ARB = angiotensin receptor blockers.

Table III.  Antithrombotic drugs at admission.

	Aspirin alone	Warfarin alone	Nothing	Other
	41% (n=406)	10% (n=99)	48% (n=474)	2% (n=20)
Age (years)	73.5±10.8^a	76.4±7.3^b	69.4±8.6^a ^b	73.9±7.6
Male	56.9%	50.5%^a	59.9%^a	50.4%
Hypertension	59.2%^a	67.7%^b	46.8%^a ^b	69.9%
Diabetes	33.7%^a	38.4%^b	17.4%^a ^b	40.1%
Current smoking	15.4%^a	8.2%^b	25.6%^a ^b	10.0%

^aP < 0.05 for comparison.

^bP < 0.01 for comparison.

Table IV.  Drugs at discharge by aspirin use status prior to admission.

	Prior aspirin	No prior aspirin
	(n=423)	(n=575)
Aspirin	95.0%	84.8%
Warfarin	15.4%	12.0%
Clopidogrel	21.9%	22.3%
Beta Blockers	93.6%	95.1%
Nitrates	79.6%^a	69.8%^a
CCB	24.5%^a	11.3%^a
Digoxin	15.2%	18.2%
ACEi or ARB	57.5%	55.7%
Diuretics	70.8%	58.6%
Statins	58.4%	57.2%

CCB = calcium channel blockers; ACEi = angiotensin converting enzyme; ARB = angiotensin receptor blockers.

^aP < 0.01 for comparison.

Figure 1.  Survival free from combined end point during follow-up according to admission aspirin (ASA) use status (P = 0.006).

Figure 2.  Survival during follow-up according to admission aspirin (ASA) use status (P = 0.03).