Abstract 2946: Does Aspirin Use Adversely Influence Intermediate Term Outcomes for Hospitalized Heart Failure Patients Who Are Treated with Angiotensin Converting Enzyme Inhibitors or Angiotensin Receptor Blockers? Findings from Optimize-HF
Objectives: To examine the effect of treatment with aspirin (ASA) and ACEI or ASA and ARB on 90 day post-discharge outcomes for patients hospitalized with ischemic and non-ischemic HF.
Methods: OPTIMIZE-HF registry data were analyzed. Patients were included if they had 90-day follow-up (n=5701), complete data and were eligible to receive ACEI or ARB on discharge. Patients were dichotomized into those with ischemic (n = 2411) or non-ischemic (n = 3290) HF and association between ASA and ACEI or ARB with outcomes was assessed using Cox proportional and logistic regression modeling. Models were adjusted for factors known to influence the outcome of interest and by propensity score.
Results: Lower risk (HR [95% CI]) of mortality (unadjusted) was observed with ACEI (0.55 [0.39, 0.77]) and ARB (0.35 [0.17, 0.72]) for ischemic and ACEI only (0.46 [0.34, 0.62]) for non-ischemic patients while the composite outcome death/rehospitalization (OR [95% CI]) was lower with ACEI and ARB for both: ischemic (0.65 [0.53, 0.89] and 0.61 [0.43, 0.85]); non-ischemic patients (0.62 [0.51, 0.75] and 0.67 [0.50, 0.90]). After adjustment, ACEI and ARB were no longer associated with mortality reduction for either group but were associated with reduced odds of the composite outcome for both: ischemic (0.72 [0.55, 0.95] and 0.71 [0.51, 0.99]); non-ischemic (0.70 [0.54, 0.89] and 0.70 [0.54, 0.92]). The interactions between ACEI/ASA and ARB/ASA in the mortality (point estimate [p-value]) and composite (p-value) models were not significant for either ischemic (−0.718 [0.086]) and −0.747 [0.329]) and (0.182 and 0.116) or non-ischemic (−0.148 [0.565] and 0.374 [0.347]) and (0.625 and 0.757) patients.
Conclusions: Use of ASA did not have a statistically significant adverse effect on intermediate term post-discharge outcomes when combined with ACEI or ARB therapy in either ischemic or non-ischemic HF patients.