Is Aspirin Any Help in Heart Failure?

Aspirin therapy has shown to benefit heart health by inhibiting blood clots and decreasing pain and inflammation. A regimen of low-dose aspirin is frequently recommended to patients at high risk of myocardial infarction. But the role of aspirin in patients with heart failure (HF) is less clear.

Some studies show that aspirin can benefit HF patients with comorbidities, such as underlying coronary artery disease, while others show aspirin use has a higher risk of morbidity than ACE inhibitors and warfarin.
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To further investigate the association of aspirin use and mortality and morbidity risk, Margaret Bermingham, PhD, Heart Failure Unit, St. Vincent’s University Hospital, Dublin, Ireland, and colleagues conducted a large retrospective cohort study including more than 1400 older adults (mean age, 70 years) enrolled in an HF disease management program.

Approximately 60% of these patients were prescribed aspirin, of whom nearly 93% were given a low dose (75 mg/d). Over a median follow-up time of 2.6 years, 31% of patients had died. The adjusted analysis showed that low-dose aspirin was associated with reduced mortality risk compared with patients not receiving aspirin (hazard ratio [HR]=.58; 95% confidence interval [CI], 0.46-.74).

Further, low-dose aspirin was associated with reduced risk of HF hospitalization compared with patients not receiving aspirin (adjusted HR=.70; 95% CI, 0.54-0.9); however, there was no different in mortality in HF hospitalization between high-dose aspirin (>75 mg/d) and non-aspirin users.

Based on these results, the researchers concluded that low-dose aspirin therapy significantly reduces HF mortality and morbidity over the long term, and that it “may have a continuing role in secondary prevention in HF.” They added that more trials of low-dose aspirin in HF patients are warranted to confirm these findings.

—Allison Musante, ELS

Reference

Bermingham M, Shanahan MK, O’Connell E; et al. Aspirin use in heart failure: is low-dose therapy associated with mortality and morbidity benefits in a large community population? Circ Heart Failure. 2014;7:243-250.