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低剂量预防性阿司匹林使用与癌症患者全因和特定原因死亡率的关联。

Association of prophylactic low-dose aspirin use with all-cause and cause-specific mortality in cancer patients.

机构信息

Department of Respiratory and Critical Care, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.

Department of Oncology, Anqing Hospital of PLA Navy, Anqing, 246004, China.

出版信息

Sci Rep. 2024 Oct 29;14(1):25918. doi: 10.1038/s41598-024-75612-w.

Abstract

The long-term use of aspirin for preventing cardiovascular disease has been recommended for decades. However, there is currently uncertainty regarding the long-term effects of aspirin use on the risk of all-cause, cardiovascular, and cancer mortality in cancer patients. The aim of this work was to analyze the connection between the prophylactic use of low-dose aspirin and the risk of all-cause death, cardiovascular death, and carcinoma death in carcinoma patients in the United States. A cohort study was conducted using National Health and Nutrition Examination Survey (NHANES) data (2011-2012, 2013-2014, 2015-2016, and 2017-2018) and associated mortality data. The 95% confidence intervals (CIs) and hazard ratios (HRs) between non-aspirin use and prophylactic low-dose aspirin use and the risk of death were measured via Cox proportional hazard regression models. A total of 1819 participants were included in the present research, of whom 945 were nonaspirin users and 874 were prophylactic aspirin users. Compared with non-aspirin users, prophylactic low-dose aspirin users had a decreased risk of all-cause death (HR = 0.647, 95% CI = 0.489-0.857). There was no statistically significant difference in the risk of cardiovascular death (HR = 0.623, 95% CI = 0.362-1.074) or cancer death (HR = 0.709, 95% CI = 0.410-1.226). Prophylactic use of low-dose aspirin may lower all-cause mortality in individuals with cancer but does not have a substantial effect on cardiovascular risk or cancer-specific mortality in this patient population.

摘要

长期以来,阿司匹林一直被推荐用于预防心血管疾病。然而,目前对于癌症患者长期使用阿司匹林对全因、心血管和癌症死亡率的影响仍存在不确定性。本研究旨在分析美国癌症患者中低剂量阿司匹林预防性使用与全因死亡、心血管死亡和癌死亡风险之间的关系。采用美国国家健康和营养调查(NHANES)数据(2011-2012 年、2013-2014 年、2015-2016 年和 2017-2018 年)和相关死亡率数据进行队列研究。使用 Cox 比例风险回归模型测量非阿司匹林使用者与预防性低剂量阿司匹林使用者之间的 95%置信区间(CI)和风险比(HR)与死亡风险之间的关系。本研究共纳入 1819 名参与者,其中 945 名非阿司匹林使用者和 874 名预防性阿司匹林使用者。与非阿司匹林使用者相比,预防性低剂量阿司匹林使用者的全因死亡风险降低(HR=0.647,95%CI=0.489-0.857)。心血管死亡风险(HR=0.623,95%CI=0.362-1.074)或癌症死亡风险(HR=0.709,95%CI=0.410-1.226)无统计学差异。在癌症患者中,预防性使用低剂量阿司匹林可能降低全因死亡率,但对该患者人群的心血管风险或癌症特异性死亡率没有显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c9/11522375/b548555e5ed5/41598_2024_75612_Fig1_HTML.jpg

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