Daily Aspirin Linked to Increased Risk of Heart Failure

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New data from a follow-up of more than 30,000 participants without heart failure at enrollment suggests that daily use of aspirin is associated with new onset heart failure.
Daily aspirin is associated with new onset heart failure (HF) independent of other risk factors, according to data derived from a database with a follow-up from more than 30,000 patients who did not have HF when they were enrolled.

These data are not relevant to primary or secondary prevention of cardiovascular events but "refer only to starting aspirin for secondary prevention of HF in patients at high risk of HF or with symptomatic HF," according to senior investigator Jan A. Staessen, MD, PhD, professor emeritus at the University of Leuven in Belgium.

In data from 30,827 patients at risk for HF enrolled in six observational studies, the hazard ratio (HR) for developing HF among those taking daily aspirin at baseline relative to those who were not was 1.26 (P ≤ .001) over 5.3 years of follow-up. In the 22,690 patients without a prior history of cardiovascular disease (CVD), the HF risk increase for exposure to daily aspirin was about the same (HR, 1.27; P = .001).

This study was launched because multiple conflicting studies have made the relationship between aspirin and HF risk unclear, according to the multinational team of authors, whose findings were published online in ESC Heart Failure.

In principle, HF is recognized as a prothrombotic condition for which an antithrombotic therapy such as aspirin would be expected to have a protective role, but the investigators pointed out that the evidence is mixed. In a population-based Danish study of 12,277 patients with new-onset HF, for example, there was no relationship seen between aspirin use and a reduction in the composite outcome of all-cause mortality, myocardial infarction, or stroke.

Aspirin Use Linked to HF Admissions

"Interestingly, this study reported that aspirin use was associated with an increased risk of readmissions for HF," wrote the authors of the newly published data. "Uncertainty on aspirin use has been reflected in current guideline recommendations," they added.

The population studied was…
Ted Bosworth
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