Background The aim of this multi-center prospective registry study was to evaluate the clinical efficacy of low-dose aspirin in vasospastic angina (VA) patients for the prevention of future cardiovascular events.
Methods A total of 1,717 patients with positive and intermediate results of an intracoronary ergonovine provocation test in the VA in Korea registry (n=2,960) were classified into 100 mg/day aspirin intake (aspirin, n=743) and no-aspirin intake (control, n=974) groups. The primary end-point was a composite of major adverse cardiac events (MACEs) including cardiac death, new-onset arrhythmia, and acute coronary syndrome.
Results The median follow-up duration was 2.0 years (25–75th, interquartile range 0.9–3.0 years). Cumulative composite MACE in the propensity score matched-pair cohort (n=1,028) was 3.6%. There was no significant difference in composite MACE between the aspirin and control groups (3.1% vs. 4.1%; hazard ratio [HR], 1.18; 95% confidence interval [CI], 0.61–2.26; p=0.623). A sensitivity analysis of only the VA-positive population showed these results to be consistent. Even for patients with minimal organic stenosis (n=369), aspirin usage was not related to the incidence of a composite MACE (HR, 1.61; 95% CI, 0.55–4.72; p=0.380).
Conclusions Low-dose aspirin does not protect against future cardiovascular events in VA patients, even patients who combine with minimal coronary artery stenosis.
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