Low-Dose Aspirin Discontinuation and Risk of Cardiovascular Events

Sundström, Johan; Hedberg, Jakob; Thuresson, Marcus; Aarskog, Pernilla; Johannesen, Kasper; Oldgren, Jonas

doi:10.1161/circulationaha.117.028321

Cited by 112 publications

(60 citation statements)

References 24 publications

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“…Given the proven benefits of aspirin in secondary prevention of cardiovascular diseases, and data suggesting no differences in serious complications, including hematoma formation [6], it is unlikely that our study results would necessitate a change in FNAB preparation practice in patients in whom the risk of a cardiovascular event may outweigh the benefit of obtaining a diagnostic sample [15, 16]. However, aspirin is the second most commonly prescribed medication without a known indication, after nonsteroidal anti-inflammatory drugs as per The Irish Longitudinal Study on Ageing (TILDA) [17].…”

Section: Discussionmentioning

confidence: 99%

Aspirin Increases the Risk of Nondiagnostic Yield of Fine-Needle Aspiration and Biopsy of Thyroid Nodules

Khan¹,

Sharma²,

Singh³

et al. 2018

Eur Thyroid J

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Background: The link between the diagnostic yield of thyroid fine-needle aspiration and biopsy (FNAB) in patients taking antithrombotic or anticoagulant medications (AT/AC) remains poorly characterized. Objectives: We studied the risk of obtaining a nondiagnostic sample with ultrasound-guided thyroid FNAB in patients taking AT/AC medications. Methods: This is a retrospective cohort study using medical records of 556 patients who underwent thyroid FNAB. All cytology samples were reported using the Bethesda classification. For patients with a nondiagnostic cytology, logistic regression was used to calculate OR for patients taking AT/AC medications. Multivariate regression was used to adjust for potential confounding variables including age, cystic ultrasound features, presence of eggshell calcifications, number of passes performed, cystic aspirate on FNAB, and position of the nodule. Results: Out of 556 patients, cytology results were available for 547 patients. Of these, 46 subjects were taking aspirin and 1 was on warfarin. Among the entire cohort, 17.5% of the subjects had a nondiagnostic cytology. Among the patients on AT/AC medications, 34% had a nondiagnostic result compared to 16% for those not taking them (OR = 2.70, p = 0.003). The subgroup of patients taking aspirin had similarly higher odds of a nondiagnostic cytology (OR = 2.78, p = 0.002). These differences remained statistically significant after multivariate adjustment. Conclusions: This is the first study to demonstrate a 3-fold independently greater risk of a nondiagnostic FNAB cytology in patients taking aspirin. Our results highlight the importance of evaluating the need for continuation of aspirin in patients undergoing thyroid FNAB as this may impact the diagnostic yield of the procedure.

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Section: Discussionmentioning

confidence: 99%

Aspirin Increases the Risk of Nondiagnostic Yield of Fine-Needle Aspiration and Biopsy of Thyroid Nodules

Khan¹,

Sharma²,

Singh³

et al. 2018

Eur Thyroid J

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“…For T2DM, reported mean medication adherence rates are only between 30% and 40%, with good versus poor adherence associated with a greater risk of mortality and hospitalization . Similar benefits have been shown with low‐dose aspirin and with angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers …”

mentioning

confidence: 85%

Adherence and diabetes

Bloomgarden

2018

Journal of Diabetes

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“…Indeed, interruption to this cardioprotection, in the form of discontinuation of low-dose aspirin, leads to a swift rebound elevation in cardiovascular risk in both primary and secondary prevention. 24 …”

Section: Vascular Wall Thromboxane/ Prostacyclin Balance Theorymentioning

confidence: 99%