RT Journal Article
SR Electronic
T1 Aspirin reduces cardiovascular events in patients with pneumonia: a prior event rate ratio analysis in a large primary care database
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2002795
DO 10.1183/13993003.02795-2020
VO 57
IS 2
A1 Fergus Hamilton
A1 David Arnold
A1 William Henley
A1 Rupert A. Payne
YR 2021
UL http://erj.ersjournals.com/content/57/2/2002795.abstract
AB Background Ischaemic stroke and myocardial infarction (MI) are common after pneumonia and are associated with long-term mortality. Aspirin may attenuate this risk and should be explored as a therapeutic option.Methods We extracted all patients with pneumonia (aged over 50 years) from the Clinical Practice Research Datalink (CPRD), a large UK primary care database, from inception until January 2019. We then performed a prior event rate ratio (PERR) analysis with propensity score matching (PSM), an approach that allows for control of measured and unmeasured confounding, with aspirin usage as the exposure and ischaemic events as the outcome. The primary outcome was the combined outcome of ischaemic stroke and MI. Secondary outcomes were ischaemic stroke and MI individually. Relevant confounders (smoking, comorbidities, age and gender) were included in the analysis.Findings 48 743 patients were eligible for matching. Of these, 9864 were aspirin users who were matched to 9864 non-users. Aspirin users had a reduced risk of the primary outcome (adjusted hazard ratio 0.64, 95% CI 0.52–0.79) in the PERR analysis. For both secondary outcomes, aspirin use was also associated with a reduced risk for MI (hazard ratio 0.46, 95% CI 0.30–0.72) and stroke (hazard ratio 0.70, 95% CI 0.55–0.91), respectively.Interpretation This study provides supporting evidence that aspirin use is associated with reduced ischaemic events after pneumonia in a primary care setting. This drug may have a future clinical role in preventing this important complication.Aspirin use was associated with reduced cardiovascular events after a pneumonia episode in a large UK primary care cohort and is a promising avenue in managing cardiovascular risk in pneumonia https://bit.ly/2YBkPXJ