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Coronary Artery Disease:
doi: 10.1097/MCA.0b013e32835d7610
Therapy and Prevention

Does aspirin use prevent acute coronary syndrome in patients with pneumonia: multicenter prospective randomized trial

Oz, Fahrettina; Gul, Sulec; Kaya, Mehmet G.b; Yazici, Mehmeth; Bulut, Ismetd; Elitok, Alia; Ersin, Gunaye; Abakay, Ozlemf; Akkoyun, Cayan D.g; Oncul, Aytaca; Cetinkaya, Erdoganc; Gibson, Michael C.i; Oflaz, Huseyina

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Objectives: The aim of this study was to test the hypothesis that aspirin would reduce the risk for acute coronary syndromes (ACSs) in patients with pneumonia.

Backgrounds: Pooled data suggest that pneumonia may trigger an ACS as a result of inflammatory reactions and the prothrombotic changes in patients with pneumonia. Hypothetically considering its antiaggregating and anti-inflammatory effects, aspirin might also be beneficial for the primary prevention of ACS in patients with pneumonia.

Methods: One hundred and eighty-five patients with pneumonia who had more than one risk factor for cardiovascular disease were randomized to an aspirin group (n=91) or a control group (n=94). The patients in the aspirin group received 300 mg of aspirin daily for 1 month. ECGs were recorded on admission and 48 h and 30 days after admission to assess silent ischemia. The level of high-sensitivity cardiac troponin T was measured on admission and 48 h after admission. The primary endpoint was the development of ACS within 1 month. The secondary endpoints included cardiovascular death and death from any cause within 1 month.

Results: The χ2-test showed that the rates of ACS at 1 month were 1.1% (n=1) in the aspirin group and 10.6% (n=10) in the control group (relative risk, 0.103; 95% confidence interval 0.005–0.746; P=0.015). Aspirin therapy was associated with a 9% absolute reduction in the risk for ACS. There was no significant decrease in the risk of death from any cause (P=0.151), but the aspirin group had a decreased risk of cardiovascular death (risk reduction: 0.04, P=0.044).

Conclusion: This randomized open-label study shows that acetyl salicylic acid is beneficial in the reduction of ACS and cardiovascular mortality among patients with pneumonia.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins


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