Thyagaturu Harshith, Ali Shafaqat, Seetharam Karthik, Upreti Prakash, Doddi Akshith, Atti Lalitsiri, Roma Nicholas, Lacoste Jordan L, Angirekula Aakash, Salami Joseph, Nasir Khurram, Balla Sudarshan
Department of Cardiology, West Virginia University School of Medicine, 1 Medical Center Dr, Morgantown, WV, 26506, USA.
Department of Internal Medicine, Louisiana State University, Shreveport, LA, USA.
Cardiol Ther. 2024 Dec;13(4):679-694. doi: 10.1007/s40119-024-00385-2. Epub 2024 Oct 5.
Since its invention in 1897, aspirin (ASA) has been the most widely used and cost-effective antiplatelet agent to prevent and treat atherosclerotic cardiovascular disease (ASCVD). We aimed to study the trends and expenditures associated with ASA use in the USA.
We conducted a serial cross-sectional analysis using the Medical Expenditure Panel Survey data from January 2000 to December 2021, focusing on adults aged ≥ 40 years. Total and out-of-pocket expenditures associated with ASA were estimated to 2021 US dollars (USD). Trends, demographics, and predictors of ASA use among patients with and without ASCVD were also evaluated.
A total of 53 million adults were identified during the study period. The number of ASA users increased from 2.9 million to 6.6 million with increased female (36.7%-49.7%; p trend = 0.02) and African American (13%-18.9%; p trend = 0.03) representation amongst all ASA users during the survey period. The use of low-dose ASA increased, while high-dose ASA declined significantly. Only 50% of all ASA users had known ASCVD. The most prevalent ASA users among patients with ASCVD were those aged ≥ 70 years, while patients without ASCVD, it was the 50-69 age group. The total annual expenditure on ASA averaged approximately 60 million USD, with 27.3 million USD out-of-pocket.
Total and low-dose (81 mg) ASA use has increased, while high-dose (325 mg) ASA has declined. ASA use for primary prevention has risen among adults aged 50-69 years, and patients ≥ 70 years continue to use ASA without known ASCVD. Further studies are needed to understand the implications of increased ASA use, especially among those without ASCVD.
自1897年发明以来，阿司匹林（ASA）一直是预防和治疗动脉粥样硬化性心血管疾病（ASCVD）最广泛使用且最具成本效益的抗血小板药物。我们旨在研究美国阿司匹林使用的趋势及相关支出。
我们利用2000年1月至2021年12月的医疗支出面板调查数据进行了系列横断面分析，重点关注年龄≥40岁的成年人。与阿司匹林相关的总支出和自付支出按2021年美元（USD）估算。还评估了有和没有ASCVD的患者中阿司匹林使用的趋势、人口统计学特征及预测因素。
研究期间共识别出5300万成年人。在调查期间，阿司匹林使用者数量从290万增加到660万，女性（从36.7%增至49.7%；p趋势=0.02）和非裔美国人（从13%增至18.9%；p趋势=0.03）在所有阿司匹林使用者中的占比增加。低剂量阿司匹林的使用增加，而高剂量阿司匹林显著下降。所有阿司匹林使用者中只有50%患有已知的ASCVD。患有ASCVD的患者中最普遍使用阿司匹林的是年龄≥70岁的人群，而没有ASCVD的患者中，是50 - 69岁年龄组。阿司匹林的年度总支出平均约为6000万美元，其中自付支出为2730万美元。
阿司匹林的总使用量和低剂量（81毫克）使用量增加，而高剂量（325毫克）使用量下降。50 - 69岁成年人中阿司匹林用于一级预防的比例上升，且年龄≥70岁的患者在没有已知ASCVD的情况下仍继续使用阿司匹林。需要进一步研究以了解阿司匹林使用增加的影响，尤其是在那些没有ASCVD的人群中。
