Long-Term Outcome of Patients With Aortic Aneurysms Taking Low-Dose Aspirin: A Population-Based Cohort Study
Long-Term Outcome of Patients With Aortic Aneurysms Taking Low-Dose Aspirin: A Population-Based Cohort Study
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DOI：
10.2310/jim.0b013e318297d0f9
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发表时间：
2013-08-01
影响因子：
2.6
通讯作者：
Huang, Yaw-Bin
中科院分区：
文献类型：
--
作者：
Chen, Chung-Yu;Huang, Jiann-Woei;Huang, Yaw-Bin
背景：有限的研究评估了小剂量阿司匹林的使用与腹主动脉瘤(AAA)、胸腹主动脉瘤(TAAA)和胸主动脉瘤(TAA)治疗的关系。本研究旨在研究小剂量阿司匹林在预防不同主动脉瘤死亡和恶化方面的相关性。方法：这项回顾性研究从国家健康保险研究数据库中确定了1999至2006年间的主动脉瘤病例，并使用时间依赖的方法来确定小剂量阿司匹林的使用是否降低了预后风险。初步结果包括死亡、主动脉夹层、破裂事件、未破裂事件或手术修复的综合结果，以及主动脉瘤事件的次要结果、死亡和再入院的综合终点。结果：确定了287例患者。根据时间依赖分析，在每90天间隔服用小剂量阿司匹林的AAA/TAAA患者与不服用阿司匹林的患者相比，主要结果的风险比为1.000(95%可信区间[CI]，0.994-1.005)，而在TAA患者中服用小剂量阿司匹林的风险比为1.010(95%CI，0.994-1.026)。在二次结局方面，AAA/TAAA患者全因死亡的风险比为0.995(95%CI，0.988-1.003)，TAA患者为1.008(95%CI，0.991-1.026)。结论：从国家人口数据库中，通过时间依赖分析，我们没有发现小剂量阿司匹林暴露与不同主动脉瘤的死亡率或恶化之间的关联。然而，无法对动脉瘤大小和吸烟状况进行调整，这可能会限制研究的有效性。
Background: Limited studies evaluated the association between low-dose aspirin use and abdominal aortic aneurysm (AAA), thoracoabdominal aortic aneurysm (TAAA), and thoracic aortic aneurysm (TAA) treatment. We conducted this study to investigative the association of low-dose aspirin in terms of preventing death and exacerbation of different aortic aneurysms.Methods: This retrospective study identified aortic aneurysm cases between 1999 and 2006 from the National Health Insurance Research Database and used time-dependent methods to determine whether the use of low-dose aspirin reduced the risk of outcomes. Primary outcomes, including a composite outcome of death, aortic dissection, a rupture event, an unruptured event, or surgical repair, and secondary outcomes, the composite end point of death and readmission for aortic aneurysm events, were estimated separately.Results: Two hundred eighty-seven cases were identified. The hazard ratio for the primary outcome in patients taking low-dose aspirin in AAA/TAAA patients at each 90-day interval based on the time-dependent analysis was 1.000 (95% confidence interval [CI], 0.994-1.005), and in TAA patients 1.010 (95% CI, 0.994-1.026) compared with those with no exposure. In terms of the secondary outcomes, the hazard ratio for all-cause mortality was 0.995 (95% CI, 0.988-1.003) for AAA/TAAA patients and 1.008 (95% CI, 0.991-1.026) for TAA patients.Conclusions: From a national population database, we did not find an association between low-dose aspirin exposure and mortality or exacerbation in different aortic aneurysms by using time-dependent analysis. However, adjustments for aneurysms size and smoking status could not be made, which may limit the validity of the study.