Ofman Peter, Petrone Andrew B, Peralta Adelqui, Hoffmeister Peter, Albert Christine M, Djousse Luc, Gaziano J Michael, Rahilly-Tierney Catherine R
Division of Cardiology, VA Boston Healthcare System and Harvard Medical School, Boston, MA (P.O., A.P., P.H., M.G.) Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.O., A.B.P., L.D., M.G., C.R.R.T.) Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), Boston Veterans Affairs Healthcare System, Boston, MA (P.O., L.D., M.G., C.R.R.T.) Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.O., M.G.).
Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.O., A.B.P., L.D., M.G., C.R.R.T.).
J Am Heart Assoc. 2014 Jun 30;3(4):e000763. doi: 10.1161/JAHA.113.000763.
Inflammatory processes have been associated with an increased risk of atrial fibrillation (AF), potentially allowing for preventive therapy by anti-inflammatory agents such as aspirin. However, the effect of chronic aspirin on the incidence of AF has not been evaluated in a prospective cohort followed for an extended period.
This study was comprised of a prospective cohort of 23 480 male participants of the Physicians' Health Study. Aspirin intake and covariates were estimated using self-reported questionnaires. Incident AF was ascertained through yearly follow-up questionnaires. Cox's regression, with adjustment for multiple covariates, was used to estimate relative risk of AF. Average age at baseline was 65.1±8.9 years. During a mean follow-up of 10.0 years, 2820 cases of AF were reported. Age-standardized incidence rates were 12.6, 11.1, 12.7, 11.3, 15.8, and 13.8/1000 person-years for people reporting baseline aspirin intake of 0, <14 days per year, 14 to 30 days per year, 30 to 120 days per year, 121 to 180 days per year, and >180 days per year, respectively. Multivariable adjusted hazard ratios (95% confidence interval) for incident AF were 1.00 (reference), 0.88 (0.76 to 1.02), 0.93 (0.76 to 1.14), 0.96 (0.80 to 1.14), 1.07 (0.80 to 1.14), and 1.04 (0.94 to 1.15) across consecutive categories of aspirin intake. Analysis of the data using time-varying Cox's regression model to update aspirin intake over time showed similar results.
In a large cohort of males followed for a long period, we did not find any association between aspirin use and incident AF.
炎症过程与心房颤动（AF）风险增加有关，这可能使阿司匹林等抗炎药物的预防性治疗成为可能。然而，长期服用阿司匹林对AF发病率的影响尚未在长期随访的前瞻性队列中进行评估。
本研究包括医师健康研究中23480名男性参与者的前瞻性队列。阿司匹林摄入量和协变量通过自我报告问卷进行评估。通过年度随访问卷确定新发AF。使用Cox回归并对多个协变量进行调整，以估计AF的相对风险。基线时的平均年龄为65.1±8.9岁。在平均10.0年的随访期间，报告了2820例AF病例。报告的基线阿司匹林摄入量为每年0天、<14天、14至30天、30至120天、121至180天和>180天的人群，年龄标准化发病率分别为每年12.6、11.1、12.7、11.3、15.8和13.8/1000人年。连续阿司匹林摄入类别中，新发AF的多变量调整风险比（95%置信区间）分别为1.00（参考值）、0.88（0.76至1.02）、0.93（0.76至1.14）、0.96（0.80至1.14）、1.07（0.80至1.14）和1.04（0.94至1.15）。使用随时间变化的Cox回归模型对阿司匹林摄入量随时间进行更新的数据分析显示了相似的结果。
在长期随访的大量男性队列中，我们未发现阿司匹林使用与新发AF之间存在任何关联。
