To evaluate the association of low-dose aspirin with primary prevention of major adverse cardiovascular events (MACE) in patients with incident giant cell arteritis (GCA).
Key Findings:
Low-dose aspirin was associated with a significant reduction in MACE (RR, 0.86) and all-cause mortality (RR, 0.82) at 1 year.
No significant reduction in myocardial infarction and stroke was observed.
Increased risk of major hemorrhage was noted (RR, 1.29).
Net clinical benefits were neutral at 1 year (RR, 1.02) and at 3 years (RR, 0.93).
Bleeding risk attenuated over time, becoming statistically non-significant at 3 years.
Interpretation:
The study suggests that while low-dose aspirin may reduce some cardiovascular risks in GCA patients, the overall net clinical benefits are neutral when considering both ischemic and bleeding outcomes.
Limitations:
Lack of randomized clinical trial (RCT) data.
Potential logistical barriers to conducting an RCT in this patient population.
Observational nature of the study may introduce biases.
Conclusion:
The findings indicate a cautious approach to low-dose aspirin use in GCA, emphasizing the need for shared decision-making that considers patient preferences regarding ischemic and bleeding risks.
