Misuse of Aspirin and Associated Factors for the Primary Prevention of Cardiovascular Disease

Yinong Chen, Chun Yin, Qing Li, Luyao Yu, Longyang Zhu, Dayi Hu, Yihong Sun, Yinong Chen, Chun Yin, Qing Li, Luyao Yu, Longyang Zhu, Dayi Hu, Yihong Sun

Abstract

Background: The value of aspirin for primary prevention continues to be debated. Data showing whether aspirin use for primary prevention adheres to established guidelines in real world practice are sparse. Methods: A total of 13,104 patients without cardiovascular diseases (CVD) were selected from the DYS-lipidemia International Study of China, a national survey of patients with dyslipidemia in 2012. The CVD risk of the participants were calculated using the 10-year risk of Ischemic Cardiovascular Diseases model. The misuse of aspirin for primary prevention was defined as having CVD risk <10% with daily aspirin. Multivariate logistic regression models were used to explore risk factors associated with aspirin misuse. Results: The proportion of the patients categorized as low, moderate and high risk for CVD were 52.9, 21.6, and 25.4% respectively. The misuse frequency of aspirin was 31.0% (2,147/6,933) in patients with low risk. The misuse of aspirin increased with aging for both men and women. In the multivariate analysis, the independent risk factors associated with aspirin misuse were hypertension, diabetes mellitus, a family history of premature CVD, and elderly age. Level of total cholesterol is negatively associated with aspirin misuse. Patients from low level hospitals are more likely to be taking aspirin inappropriately. Results remained consistent after including 2,837 patients having 10-year risk for CVD between 10 and <20%. Conclusion: The misuse of aspirin for primary prevention is common in patients having CVD risk <10%. There are important opportunities to improve evidence-based aspirin use for the primary prevention of CVD in Chinese patients. Clinical Trial Registration:https://ichgcp.net/clinical-trials-registry/NCT01732952" title="See in ClinicalTrials.gov">NCT01732952].

Keywords: aspirin; cardiovascular disease; overuse; primary prevention; risk factors.

Conflict of interest statement

This study received funding from a research grant from MoShaDong China. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication. All authors declare no other competing interests. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Chen, Yin, Li, Yu, Zhu, Hu and Sun.

Figures

Figure 1
Figure 1
Flow chart of study participants.

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