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Prior aspirin use predicts worse outcomes in patients with non–ST-elevation acute coronary syndromes

Aspirin is beneficial in the prevention and treatment of cardiovascular events, but patients who have events while taking aspirin may have worse outcomes than those not on aspirin. We investigated the association between prior aspirin use and clinical outcomes in 9,461 patients with non–ST-elevation...

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Published in:The American journal of cardiology 1999-04, Vol.83 (8), p.1147-1151
Main Authors: Alexander, John H, Harrington, Robert A, Tuttle, Robert H, Berdan, Lisa G, Lincoff, A.Michael, Deckers, Jaap W, Simoons, Maarten L, Guerci, Alan, Hochman, Judith S, Wilcox, Robert G, Kitt, Michael M, Eisenberg, Paul R, Califf, Robert M, Topol, Eric J, Karsh, Karl, Ruzyllo, Witold, Stepinska, Janine, Widimsky, Peter, Boland, Jean B, Armstrong, Paul W
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container_issue 8
container_start_page 1147
container_title The American journal of cardiology
container_volume 83
creator Alexander, John H
Harrington, Robert A
Tuttle, Robert H
Berdan, Lisa G
Lincoff, A.Michael
Deckers, Jaap W
Simoons, Maarten L
Guerci, Alan
Hochman, Judith S
Wilcox, Robert G
Kitt, Michael M
Eisenberg, Paul R
Califf, Robert M
Topol, Eric J
Karsh, Karl
Ruzyllo, Witold
Stepinska, Janine
Widimsky, Peter
Boland, Jean B
Armstrong, Paul W
description Aspirin is beneficial in the prevention and treatment of cardiovascular events, but patients who have events while taking aspirin may have worse outcomes than those not on aspirin. We investigated the association between prior aspirin use and clinical outcomes in 9,461 patients with non–ST-elevation acute coronary syndromes enrolled in the Platelet IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial, before and after adjustment for baseline factors. We also examined whether eptifibatide has a differential treatment effect in prior aspirin users. Prior aspirin users were less likely to have an enrollment myocardial infarction (MI) (vs unstable angina) (43.9% vs 48.8%, p = 0.001) but more likely to have death or MI at 30 days (16.1% vs 13.0%, p = 0.001) and at 6 months (19.9% vs 15.9%, p = 0.001). After adjustment, prior aspirin users remained less likely to have an enrollment MI (odds ratio 0.88, 95% confidence interval 0.79 to 0.97) and more likely to have death or MI at 30 days (odds ratio 1.16, 95% confidence interval 1.00 to 1.33) but not at 6 months (odds ratio 1.14, 95% confidence interval 0.98 to 1.33). In a multivariable model, eptifibatide did not have a different treatment effect in prior aspirin users compared with nonusers (p = 0.534). Prior aspirin users had fewer enrollment MIs but worse long-term outcomes than nonusers. We found no evidence for a different treatment effect of eptifibatide in prior aspirin users.
doi_str_mv 10.1016/S0002-9149(99)00049-1
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identifier ISSN: 0002-9149
ispartof The American journal of cardiology, 1999-04, Vol.83 (8), p.1147-1151
issn 0002-9149
1879-1913
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source ScienceDirect Journals
subjects Aspirin
Biological and medical sciences
Cardiology
Cardiovascular disease
Cardiovascular system
Clinical outcomes
Drug therapy
Health risk assessment
Medical sciences
Miscellaneous
Pharmacology. Drug treatments
title Prior aspirin use predicts worse outcomes in patients with non–ST-elevation acute coronary syndromes
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