Barbieri Maria Antonietta, Peker Dilsad Simay, Askar Mohsen Gamal Saad, Battini Vera, Abate Andrea, Carnovale Carla, Clementi Emilio, Ofori-Asenso Richard, Spina Edoardo, Pareek Manan, Kragholm Kristian, Torp-Pedersen Christian, Sessa Maurizio
Department of Drug Design and Pharmacology, University of Copenhagen, Denmark.
Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy.
Eur Heart J Qual Care Clin Outcomes. 2024 Oct 11. doi: 10.1093/ehjqcco/qcae089.
To assess the risk of anaemia among low-dose aspirin (LDA) exposure in Danish older individuals in a real-world setting.
Population based-cohort study conducted using Danish registers. The study population included older individuals (≥65 years) exposed to LDA between 2008 and 2013 for primary or secondary prevention of cardiovascular events. Over a five-year follow-up, outcomes included anaemia incidence based on haemoglobin values and hematinic deficiency incidence based on antianemic prescriptions.
Among the 313 508 individuals included in the study population, those exposed to LDA (n = 59 869, 19.1%) had an incidence of hematinic deficiency determined by the use of antianemic treatment of 9.6%, with an incidence rate ratio of 9.11 (95% Confidence Interval, CI: 8.81-9.41) when compared to non-users of LDA (n = 253 639, 80.9%), who had an incidence of 3.7%. Anaemia determined by haemoglobin value measurements was observed in 5.9% of those exposed to LDA, with an incidence rate ratio of 7.89 (95% CI: 7.58-8.21) when compared to non-users of LDA. Approximately one in five individuals (n = 2 422, 21.5%) who experienced anaemia also experienced bleeding. Severe anaemia was observed in 1.3% of those exposed to LDA compared to 0.6% of those not exposed. Among the exposed, the reduction in haemoglobin and ferritin levels was associated with the severity of anaemia.
These findings indicate that in a real-world setting, anaemia with LDA can occur in 6 to 10 older individuals out of every 100 LDA users during the first 5 years of treatment.
在真实环境中评估丹麦老年人低剂量阿司匹林（LDA）暴露导致贫血的风险。
使用丹麦登记册进行基于人群的队列研究。研究人群包括2008年至2013年间因心血管事件的一级或二级预防而暴露于LDA的老年人（≥65岁）。在五年随访期间，结局包括基于血红蛋白值的贫血发病率和基于抗贫血处方的造血物质缺乏发病率。
在纳入研究人群的313508人中，暴露于LDA的人群（n = 59869，19.1%）使用抗贫血治疗确定的造血物质缺乏发病率为9.6%，与未使用LDA的人群（n = 253639，80.9%）相比，发病率比为9.11（95%置信区间，CI：8.81 - 9.41），后者发病率为3.7%。通过血红蛋白值测量确定的贫血在暴露于LDA的人群中占5.9%，与未使用LDA的人群相比，发病率比为7.89（95% CI：7.58 - 8.21）。经历贫血的个体中约五分之一（n = 2422，21.5%）也经历了出血。暴露于LDA的人群中1.3%出现严重贫血，未暴露人群中这一比例为0.6%。在暴露人群中，血红蛋白和铁蛋白水平的降低与贫血的严重程度相关。
这些发现表明，在真实环境中，每100名LDA使用者中，在治疗的前5年里，有6至10名老年人会因LDA发生贫血。
