A Short-Term Effect of Low-Dose Aspirin on Major Hemorrhagic Risks in Primary Prevention: A Case-Crossover Design |
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Authors: | I-Chen Wu Ming-Yen Lin Fang-Jung Yu Hui-Min Hsieh Kuei-Fen Chiu Ming-Tsang Wu |
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Affiliation: | 1. Kaohsiung Medical University, Kaohsiung, Taiwan.; 2. Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.; 3. Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.; 4. Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.; Universidad de Valladolid, Spain, |
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Abstract: | BackgroundVery few studies have examined the risk of short-term adverse hemorrhage of low-dose aspirin use in primary prevention. This case-crossover study examined the transient effect of low-dose aspirin use on major hemorrhagic risks.MethodsA representative database of 1,000,000 patients randomly sampled from the Taiwan''s National Health Insurance Research Database in 2000 was analyzed. The study cohort consisted of a total of 501,946 individuals, aged 30–95 years old, at risk of a major bleeding event in 2000. A case-crossover study was used to retrieve data on 10,905 incident patients with major hemorrhagic complications (3,781 cerebral and 7,124 gastrointestinal) and prescribed low-dose aspirin (≤300 mg/day) from 2000–2008. A 56-day time window (∼2 months) was used as the case period for which the odds ratio (OR) was estimated using the ratio of patients exposed during the 56-day case period only (1–56 days before the index date) compared to its corresponding 56-day control period only (57–112 days before the index date).ResultsFour hundred eighty-nine (4.5%) of the 10,905 hemorrhagic patients had used low-dose aspirin during the 56-day case only period; 294 (2.7%) of the same patients had used low-dose aspirin during control only period. Low-dose aspirin use increase the risk of developing a major hemorrhage 1.33-fold (95% CI = 1.13–1.55, P<0.0001). Significance was found prominent in 4,453 non-hypertensive and non-diabetic subjects (Adjusted odds ratio = 1.88, 95% CI = 1.21–2.91).ConclusionTransient low-dose aspirin use increases risk for major hemorrhagic events in Han Chinese. |
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