tetano
Editor, Senior Moderator
Int J Cardiol
. 2021 Oct 4;S0167-5273(21)01499-6.
doi: 10.1016/j.ijcard.2021.09.058. Online ahead of print.
Pre-admission acetylsalicylic acid therapy and impact on in-hospital outcome in COVID-19 patients: The ASA-CARE study
Antonio Sisinni[SUP] 1 [/SUP], Luca Rossi[SUP] 2 [/SUP], Antonio Battista[SUP] 1 [/SUP], Enrico Poletti[SUP] 3 [/SUP], Federica Battista[SUP] 4 [/SUP], Rosa Alessia Battista[SUP] 5 [/SUP], Alessandro Malagoli[SUP] 2 [/SUP], Andrea Biagi[SUP] 2 [/SUP], Alessia Zanni[SUP] 2 [/SUP], Concetta Sticozzi[SUP] 2 [/SUP], Greta Comastri[SUP] 2 [/SUP], Massimiliano M Marrocco-Trischitta[SUP] 6 [/SUP], Alberto Monello[SUP] 2 [/SUP], Alberto Margonato[SUP] 7 [/SUP], Francesco Bandera[SUP] 1 [/SUP], Pasquale Vergara[SUP] 8 [/SUP], Marco Guazzi[SUP] 9 [/SUP], Cosmo Godino[SUP] 10 [/SUP]
Affiliations
Abstract
Background: Patients with coronavirus disease 2019 (COVID-19) exhibit high thrombotic risk. The evidence on a potential independent prognostic role of antiplatelet treatment in those patients is limited. The aim of the study was to evaluate the prognostic impact of pre-admission low-dose acetylsalicylic acid (ASA) in a wide series of hospitalized patients with COVID-19.
Methods: This cohort study included 984 COVID-19 patients stratified according to ASA intake before hospitalization: ASA[SUP]+[/SUP] (n = 253) and ASA[SUP]-[/SUP] (n = 731). Patients were included in ASA[SUP]+[/SUP] group if they received it daily in the 7 days before admission. 213 (83%) were on ASA 100 mg daily. Primary endpoint was a composite of in-hospital death and/or need for respiratory support upgrade, secondary endpoints were in-hospital death and need for respiratory support upgrade.
Results: Mean age was 72 [62; 81] with 69% of male patients. ASA[SUP]+[/SUP] patients were significantly older, with higher prevalence of comorbidities. No significant differences regarding the degree of respiratory dysfunction were observed. At 30-day Kaplan-Meier analysis, ASA[SUP]+[/SUP] patients had higher survival free from the primary endpoint and need for respiratory support upgrade, conversely in-hospital death did not significantly differ between groups. At multivariate analysis ASA intake was independently associated with a lower probability of reaching primary endpoint (HR 0.697, 95% C.I. 0.525-0.924; p = 0.012).
Conclusions: In COVID-19 patients undergoing hospitalization, pre-admission treatment with ASA is associated with better in-hospital outcome, mainly driven by less respiratory support upgrade.
Keywords: Acetylsalicylic acid; COVID-19; Platelet aggregation inhibitors; SARS-CoV-2; Thrombosis.
. 2021 Oct 4;S0167-5273(21)01499-6.
doi: 10.1016/j.ijcard.2021.09.058. Online ahead of print.
Pre-admission acetylsalicylic acid therapy and impact on in-hospital outcome in COVID-19 patients: The ASA-CARE study
Antonio Sisinni[SUP] 1 [/SUP], Luca Rossi[SUP] 2 [/SUP], Antonio Battista[SUP] 1 [/SUP], Enrico Poletti[SUP] 3 [/SUP], Federica Battista[SUP] 4 [/SUP], Rosa Alessia Battista[SUP] 5 [/SUP], Alessandro Malagoli[SUP] 2 [/SUP], Andrea Biagi[SUP] 2 [/SUP], Alessia Zanni[SUP] 2 [/SUP], Concetta Sticozzi[SUP] 2 [/SUP], Greta Comastri[SUP] 2 [/SUP], Massimiliano M Marrocco-Trischitta[SUP] 6 [/SUP], Alberto Monello[SUP] 2 [/SUP], Alberto Margonato[SUP] 7 [/SUP], Francesco Bandera[SUP] 1 [/SUP], Pasquale Vergara[SUP] 8 [/SUP], Marco Guazzi[SUP] 9 [/SUP], Cosmo Godino[SUP] 10 [/SUP]
Affiliations
- PMID: 34619262
- DOI: 10.1016/j.ijcard.2021.09.058
Abstract
Background: Patients with coronavirus disease 2019 (COVID-19) exhibit high thrombotic risk. The evidence on a potential independent prognostic role of antiplatelet treatment in those patients is limited. The aim of the study was to evaluate the prognostic impact of pre-admission low-dose acetylsalicylic acid (ASA) in a wide series of hospitalized patients with COVID-19.
Methods: This cohort study included 984 COVID-19 patients stratified according to ASA intake before hospitalization: ASA[SUP]+[/SUP] (n = 253) and ASA[SUP]-[/SUP] (n = 731). Patients were included in ASA[SUP]+[/SUP] group if they received it daily in the 7 days before admission. 213 (83%) were on ASA 100 mg daily. Primary endpoint was a composite of in-hospital death and/or need for respiratory support upgrade, secondary endpoints were in-hospital death and need for respiratory support upgrade.
Results: Mean age was 72 [62; 81] with 69% of male patients. ASA[SUP]+[/SUP] patients were significantly older, with higher prevalence of comorbidities. No significant differences regarding the degree of respiratory dysfunction were observed. At 30-day Kaplan-Meier analysis, ASA[SUP]+[/SUP] patients had higher survival free from the primary endpoint and need for respiratory support upgrade, conversely in-hospital death did not significantly differ between groups. At multivariate analysis ASA intake was independently associated with a lower probability of reaching primary endpoint (HR 0.697, 95% C.I. 0.525-0.924; p = 0.012).
Conclusions: In COVID-19 patients undergoing hospitalization, pre-admission treatment with ASA is associated with better in-hospital outcome, mainly driven by less respiratory support upgrade.
Keywords: Acetylsalicylic acid; COVID-19; Platelet aggregation inhibitors; SARS-CoV-2; Thrombosis.