Author + information
- Received July 30, 2004
- Revision received April 11, 2005
- Accepted April 19, 2005
- Published online September 20, 2005.
- Edward L. Portnay, MD⁎,
- JoAnne M. Foody, MD⁎,
- Saif S. Rathore, MPH⁎,
- Yongfei Wang, MS⁎,
- Frederick A. Masoudi, MD, MSPH†,‡,§,
- Jeptha P. Curtis, MD⁎ and
- Harlan M. Krumholz, MD, SM, FACC⁎∥,¶,#,⁎ ()
- ↵⁎Address for correspondence:
Dr. Harlan M. Krumholz, Yale University School of Medicine, 333 Cedar Street, P.O. Box 208088, New Haven, Connecticut 06520.
Objectives We sought to assess the association between prior aspirin use and mortality, all-cause readmission, and condition-specific readmission at one month and six months in a national sample of Medicare beneficiaries hospitalized with a confirmed myocardial infarction (MI).
Background Prior aspirin use is considered a marker of higher risk in patients with MI, yet the prognostic significance of this factor has been debated.
Methods Medicare beneficiaries ≥65 years old hospitalized with MI were evaluated to determine whether there was an association between prior aspirin use and mortality (n = 118,992), all-cause readmission, and condition-specific readmission (n = 78,975) at one month and six months.
Results One-third of the patients (n = 39,531, 33.2%) were using aspirin before admission. Those with prior aspirin use had significantly lower mortality at one month (16.1% vs. 19.0%, p < 0.0001) and six months (24.7% vs. 27.5%, p < 0.0001). After multivariable adjustment, prior aspirin use was found to be associated with a lower risk of one-month (relative risk ratio 0.93, 95% confidence interval [CI] 0.90 to 0.96) and six-month mortality (hazard ratio 0.94, 95% CI 0.91 to 0.96). Prior aspirin use tended to reduce all-cause or coronary artery disease readmissions at one month or six months.
Conclusions Prior aspirin use is not a marker of increased mortality in patients ≥65 years old hospitalized with MI.
Dr. Foody is supported by NIH/NIA Research Career Award K08-AG20623-01 and NIA/Hartford Foundation Fellowship in Geriatrics. Mr. Rathore is supported by an NIH National Institute of General Medical Sciences Medical Scientist Training Grant GM07205. Dr. Masoudi is supported by NIH Research Career Award K08-AG01011. The analyses upon which this publication is based were performed under Contract Number 500-02-CO-01 entitled “Utilization and Quality Control Peer Review Organization for the State of Colorado” sponsored by the Centers for Medicare and Medicaid Services (CMS, formerly the Health Care Financing Administration), Department of Health and Human Services. The content of the publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. government. The authors assume full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by the Health Care Financing Administration, which has encouraged identification of quality improvement projects from analysis of patterns of care, and therefore required no special funding on the part of this contractor. Ideas and contributions to the author concerning experiences in engaging with issues presented are welcomed.
- Received July 30, 2004.
- Revision received April 11, 2005.
- Accepted April 19, 2005.
- American College of Cardiology Foundation