| アブストラクト | Observational studies that have reported an association between aspirin use in chronic obstructive pulmonary disease (COPD) with reductions in mortality and COPD exacerbations were shown to be affected by time-related biases. We assessed this association using a prevalent new-user study design that avoids these biases. We used the United Kingdom's Clinical Practice Research Datalink (CPRD) to form a cohort of patients with COPD. Aspirin initiators were matched on time and propensity score with nonusers during 2002-2018. The outcomes were all-cause mortality and COPD exacerbation within a one-year follow-up. Hazard ratios (HR) and 95% confidence interval (CI) of each outcome associated with aspirin use compared to nonuse were estimated using an as-treated approach. The study cohort included 10,287 initiators of aspirin and 10,287 matched nonusers. The cumulative incidence of all-cause mortality at one year was 11.5% for aspirin users and 9.2% for nonusers. The HR of all-cause mortality associated with aspirin initiation was 1.22 (95% CI: 1.08-1.37), while for severe exacerbation it was 1.21 (95% CI 1.08-1.37), compared with nonuse. The HR of a first moderate or severe exacerbation with aspirin use was 0.90 (95% CI 0.85-0.95). These estimates did not vary by platelet count. This large population-based study, designed to emulate a trial, found aspirin use in patients with COPD associated with a higher risk of all-cause mortality and severe exacerbation, but a lower risk of moderate or severe exacerbation. Further research is warranted to assess this reduction in moderate or severe exacerbations, particularly in patients with cardiovascular risk factors. |
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| ジャーナル名 | COPD |
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| 投稿日 | 2024/3/14 |
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| 投稿者 | Khouri, Charles; Dell'Aniello, Sophie; Ernst, Pierre; Suissa, Samy |
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| 組織名 | Centre for Clinical Epidemiology, Lady Davis Institute-Jewish General Hospital,;Montreal, Canada.;Univ. Grenoble Alpes, Pharmacovigilance Unit, Grenoble Alpes University Hospital,;Grenoble, France.;Univ. Grenoble Alpes, HP2 Laboratory, INSERM U 1300, Grenoble, France.;Departments of Epidemiology and Biostatistics, and Medicine, McGill University, |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38482840/ |
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