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KMID : 1039620170070040513
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Korean Journal of Family Practice
2017 Volume.7 No. 4 p.513 ~ p.519
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Primary Prevention Effectiveness of Aspirin in Korean Elderly: Effect of Aspirin on Mortality in Elderly Patients with Hypertension, Diabetes Mellitus or Dyslipidemia
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Choi Seung-Hyun
Yoon Jong-Lull
Cheong Soo-Jin
Lee Ae-Young
Kim Hak-Sun
Jung Yu-Jin
Kim Mee-Young
Cho Jung-Jin
Ju Young-Su
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Abstract
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Background: Aspirin is well known for its central role as an antiplatelet agent in preventing cardio-cerebro-vascular diseases. Its secondary prevention effect is well established; however, its use in primary prevention of cardiovascular or cebrovascular disease in healthy people is still controversial. The aim of this study was to estimate the effect of aspirin in elderly patients with hypertension, diabetes mellitus, or dyslipidemia.
Methods: A retrospective study was conducted using data from the National Health Insurance Service Senior Cohort. Patients with past medical history of cardio-cerebro-vascular disease or cancers and medication history of antiplatelet agents such as aspirin, warfarin, and clopidogrel were excluded from the study, while patients with one or more of the chronic diseases hypertension, diabetes mellitus, and dyslipidemia were included (n=145,769). We analyzed mortality from 2003 to 2007 in the no aspirin group and in groups taking aspirin for 1 year, 2 to 3 years, and 3 to 5 years.
Results: Total mortality was 9.8% in the control group and 16.0% (hazard ratio [HR], 1.5; 95% confidence interval [CI], 1.6?2.5), 17.7% (HR, 1.6; 95% CI, 1.5?1.8), and 18.4% (HR, 2.0; 95% CI, 1.3?3.0) in the groups taking aspirin for 1 year, 2 to 3 years, and 3 to 5 years, respectively. Mortality caused by cardiovascular or cerebrovascular disease was higher in aspirin groups than in the control group.
Conclusion: We found that the use of aspirin for primary prevention increased total mortality and mortality due to cardiovascular and cerebrovascular disease in elderly Korean patients over 60 years of age with one or more chronic diseases.
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KEYWORD
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Aspirin, Mortality, Primary Prevention, Cardiovascular Disease, Cerebrovascular Disease, Aged
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