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Aspirin Does Not Increase Heart Failure Events in Heart Failure Patients: From the WARCEF Trial.
Teerlink, John R; Qian, Min; Bello, Natalie A; Freudenberger, Ronald S; Levin, Bruce; Di Tullio, Marco R; Graham, Susan; Mann, Douglas L; Sacco, Ralph L; Mohr, J P; Lip, Gregory Y H; Labovitz, Arthur J; Lee, Seitetz C; Ponikowski, Piotr; Lok, Dirk J; Anker, Stefan D; Thompson, John L P; Homma, Shunichi.
Afiliação
  • Teerlink JR; Section of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California San Francisco, San Francisco, California.
  • Qian M; Columbia University Medical Center, New York, New York.
  • Bello NA; Columbia University Medical Center, New York, New York.
  • Freudenberger RS; Lehigh Valley Hospital, Allentown, Pennsylvania.
  • Levin B; Columbia University Medical Center, New York, New York.
  • Di Tullio MR; Columbia University Medical Center, New York, New York.
  • Graham S; State University of New York at Buffalo, Buffalo, New York.
  • Mann DL; Washington University, St. Louis, Missouri.
  • Sacco RL; University of Miami, Miami, Florida.
  • Mohr JP; Columbia University Medical Center, New York, New York.
  • Lip GYH; Institute of Birmingham Centre for Cardiovascular Sciences, Birmingham, England, United Kingdom.
  • Labovitz AJ; University of South Florida, Tampa, Florida.
  • Lee SC; Columbia University Medical Center, New York, New York.
  • Ponikowski P; Military Hospital, Wroclaw, Poland.
  • Lok DJ; Deventer Hospital, Deventer, the Netherlands.
  • Anker SD; Innovative Clinical Trials, Department of Cardiology & Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany.
  • Thompson JLP; Columbia University Medical Center, New York, New York.
  • Homma S; Columbia University Medical Center, New York, New York. Electronic address: sh23@cumc.columbia.edu.
JACC Heart Fail ; 5(8): 603-610, 2017 08.
Article em En | MEDLINE | ID: mdl-28774396
OBJECTIVES: The aim of this study was to determine whether aspirin increases heart failure (HF) hospitalization or death in patients with HF with reduced ejection fraction receiving an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB). BACKGROUND: Because of its cyclooxygenase inhibiting properties, aspirin has been postulated to increase HF events in patients treated with ACE inhibitors or ARBs. However, no large randomized trial has addressed the clinical relevance of this issue. METHODS: We compared aspirin and warfarin for HF events (hospitalization, death, or both) in the 2,305 patients enrolled in the WARCEF (Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction) trial (98.6% on ACE inhibitor or ARB treatment), using conventional Cox models for time to first event (489 events). In addition, to examine multiple HF hospitalizations, we used 2 extended Cox models, a conditional model and a total time marginal model, in time to recurrent event analyses (1,078 events). RESULTS: After adjustment for baseline covariates, aspirin- and warfarin-treated patients did not differ in time to first HF event (adjusted hazard ratio: 0.87; 95% confidence interval: 0.72 to 1.04; p = 0.117) or first hospitalization alone (adjusted hazard ratio: 0.88; 95% confidence interval: 0.73 to 1.06; p = 0.168). The extended Cox models also found no significant differences in all HF events or in HF hospitalizations alone after adjustment for covariates. CONCLUSIONS: Among patients with HF with reduced ejection fraction in the WARCEF trial, there was no significant difference in risk of HF events between the aspirin and warfarin-treated patients. (Warfarin Versus Aspirin in Reduced Cardiac Ejection Fraction trial [WARCEF]; NCT00041938).
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Aspirina / Inibidores de Ciclo-Oxigenase / Insuficiência Cardíaca Tipo de estudo: Clinical_trials Limite: Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Aspirina / Inibidores de Ciclo-Oxigenase / Insuficiência Cardíaca Tipo de estudo: Clinical_trials Limite: Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article