Antiplatelet agents and survival: a cohort analysis from the Studies of Left Ventricular Dysfunction (SOLVD) trial
AS Al-Khadra,
DN Salem,
WM Rand,
JE Udelson,
JJ Smith,
and
MA Konstam
Department of Medicine, New England Medical Center Hospitals, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
OBJECTIVES: This study sought to evaluate the relation between antiplatelet agent (APA) use and survival and morbidity from cardiac disease in patients with left ventricular (LV) systolic dysfunction. BACKGROUND: APAs play an important role in the prevention and treatment of coronary disease. Their effects in patients with LV systolic dysfunction are unknown. METHODS: We reviewed data on APA use in 6,797 patients enrolled in the Studies of Left Ventricular Dysfunction (SOLVD) trial and analyzed the relation between their use and all-cause mortality as well as the combined end point of death or hospital admission for heart failure (HF). We used Cox regression to adjust for differences in baseline characteristics and to test for the interaction between APA use and selected patient variables in relation to outcome. RESULTS: APA use (46.3% of patients) was associated with significantly reduced mortality from all causes (adjusted hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.73 to 0.92, p = 0.0005) and reduced risk of death or hospital admission for HF (adjusted HR 0.81, 95% CI 0.74 to 0.89, p < 0.0001) but was not influenced by trial assignment, gender, LV ejection fraction, New York Heart Association class or etiology. A strong interaction was observed among APA use, randomization group and all-cause mortality. The association between APA use and survival was not observed in the enalapril group, nor was an enalapril benefit on survival detectable in patients receiving APAs at baseline. However, randomization to enalapril therapy significantly reduced the combined end point of death or hospital admission for HF in APA users. CONCLUSIONS: In patients with LV systolic dysfunction, use of APAs is associated with improved survival and reduced morbidity. This association is retained after adjustment for baseline characteristics. APA use is associated with retained but reduced benefit from enalapril.
This article has been cited by other articles:
|
|
|
|
 
L.-P. Kan, K.-M. Chu, and G.-M. Lin
Letter by Kan et al Regarding Article, "Randomized Trial of Warfarin, Aspirin, and Clopidogrel in Patients With Chronic Heart Failure: The Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) Trial"
Circulation,
November 17, 2009;
120(20):
e164 - e164.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, K. Michl, et al.
2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation
J. Am. Coll. Cardiol.,
April 14, 2009;
53(15):
e1 - e90.
[Full Text]
[PDF]
|
|
|
|
|
|
|
2005 WRITING COMMITTEE MEMBERS, S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, et al.
2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation
Circulation,
April 14, 2009;
119(14):
e391 - e479.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Konstam
Antithrombotic Therapy in Heart Failure: WATCHful Wondering
Circulation,
March 31, 2009;
119(12):
1559 - 1561.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. M. Massie, J. F. Collins, S. E. Ammon, P. W. Armstrong, J. G.F. Cleland, M. Ezekowitz, S. M. Jafri, W. F. Krol, C. M. O'Connor, K. A. Schulman, et al.
Randomized Trial of Warfarin, Aspirin, and Clopidogrel in Patients With Chronic Heart Failure: The Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) Trial
Circulation,
March 31, 2009;
119(12):
1616 - 1624.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. D. Flaherty, J. J. Bax, L. De Luca, J. S. Rossi, C. J. Davidson, G. Filippatos, P. P. Liu, M. A. Konstam, B. Greenberg, M. R. Mehra, et al.
Acute heart failure syndromes in patients with coronary artery disease early assessment and treatment.
J. Am. Coll. Cardiol.,
January 20, 2009;
53(3):
254 - 263.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Juhlin, B. A.G. Jonsson, and P. Hoglund
Renal effects of aspirin are clearly dose-dependent and are of clinical importance from a dose of 160 mg
Eur J Heart Fail,
September 1, 2008;
10(9):
892 - 898.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Patrono, C. Baigent, J. Hirsh, and G. Roth
Antiplatelet Drugs: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest,
June 1, 2008;
133(6_suppl):
199S - 233S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. C. Becker, T. W. Meade, P. B. Berger, M. Ezekowitz, C. M. O'Connor, D. A. Vorchheimer, G. H. Guyatt, D. B. Mark, and R. A. Harrington
The Primary and Secondary Prevention of Coronary Artery Disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest,
June 1, 2008;
133(6_suppl):
776S - 814S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Juhlin, L. R. Erhardt, H. Ottosson, B. A.G. Jonsson, and P. Hoglund
Treatments with losartan or enalapril are equally sensitive to deterioration in renal function from cyclooxygenase inhibition
Eur J Heart Fail,
February 1, 2007;
9(2):
191 - 196.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Gheorghiade, G. Sopko, L. De Luca, E. J. Velazquez, J. D. Parker, P. F. Binkley, Z. Sadowski, K. S. Golba, D. L. Prior, J. L. Rouleau, et al.
Navigating the Crossroads of Coronary Artery Disease and Heart Failure
Circulation,
September 12, 2006;
114(11):
1202 - 1213.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Nair, B. Sealove, J. L. Halperin, G. Webber, and V. Fuster
Anticoagulation in patients with heart failure: who, when, and why?
Eur. Heart J. Suppl.,
September 1, 2006;
8(suppl_E):
E32 - E38.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Jhund and J. J.V. McMurray
Does Aspirin Reduce the Benefit of an Angiotensin-Converting Enzyme Inhibitor?: Choosing Between the Scylla of Observational Studies and the Charybdis of Subgroup Analysis
Circulation,
June 6, 2006;
113(22):
2566 - 2568.
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. A. McAlister, W. A. Ghali, Y. Gong, J. Fang, P. W. Armstrong, and J. V. Tu
Aspirin Use and Outcomes in a Community-Based Cohort of 7352 Patients Discharged After First Hospitalization for Heart Failure
Circulation,
June 6, 2006;
113(22):
2572 - 2578.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Vorchheimer and R. Becker
Platelets in Atherothrombosis
Mayo Clin. Proc.,
January 1, 2006;
81(1):
59 - 68.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Patrono, L. A. Garcia Rodriguez, R. Landolfi, and C. Baigent
Low-dose aspirin for the prevention of atherothrombosis.
N. Engl. J. Med.,
December 1, 2005;
353(22):
2373 - 2383.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Juhlin, S. Bjorkman, and P. Hoglund
Cyclooxygenase inhibition causes marked impairment of renal function in elderly subjects treated with diuretics and ACE-inhibitors
Eur J Heart Fail,
October 1, 2005;
7(6):
1049 - 1056.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. A. Masoudi, P. Wolfe, E. P. Havranek, S. S. Rathore, J. M. Foody, and H. M. Krumholz
Aspirin Use in Older Patients With Heart Failure and Coronary Artery Disease: National Prescription Patterns and Relationship With Outcomes
J. Am. Coll. Cardiol.,
September 20, 2005;
46(6):
955 - 962.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. M. Massie
Aspirin Use in Chronic Heart Failure: What Should We Recommend to the Practitioner?
J. Am. Coll. Cardiol.,
September 20, 2005;
46(6):
963 - 966.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Fossum, A. Moan, S. E. Kjeldsen, R. B. Devereux, S. Julius, S. M. Snapinn, J. M. Edelman, U. de Faire, F. Fyhrquist, H. Ibsen, et al.
The Effect of Losartan Versus Atenolol on Cardiovascular Morbidity and Mortality in Patients With Hypertension Taking Aspirin: The Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) Study
J. Am. Coll. Cardiol.,
September 6, 2005;
46(5):
770 - 775.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Juhlin, S. Bjorkman, B. Gunnarsson, A. Fyge, B. Roth, and P. Hoglund
Acute administration of diclofenac, but possibly not long term low dose aspirin, causes detrimental renal effects in heart failure patients treated with ACE-inhibitors
Eur J Heart Fail,
December 1, 2004;
6(7):
909 - 916.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Patrono, B. Coller, G. A. FitzGerald, J. Hirsh, and G. Roth
Platelet-Active Drugs: The Relationships Among Dose, Effectiveness, and Side Effects: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy
Chest,
September 1, 2004;
126(3_suppl):
234S - 264S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Aumegeat, N. Lamblin, P. de Groote, E. P. Mc Fadden, A. Millaire, C. Bauters, and J.-M. Lablanche
Aspirin Does Not Adversely Affect Survival in Patients With Stable Congestive Heart Failure Treated With Angiotensin-Converting Enzyme Inhibitors
Chest,
October 1, 2003;
124(4):
1250 - 1258.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Meune, J.-J. Mourad, J.-F. Bergmann, and C. Spaulding
Interaction between cyclooxygenase and the renin-angiotensin-aldosterone system: rationale and clinical relevance
Journal of Renin-Angiotensin-Aldosterone System,
September 1, 2003;
4(3):
149 - 154.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. Guazzi, R. Brambilla, G. Reina, G. Tumminello, and M. D. Guazzi
Aspirin-Angiotensin-Converting Enzyme Inhibitor Coadministration and Mortality in Patients With Heart Failure: A Dose-Related Adverse Effect of Aspirin
Arch Intern Med,
July 14, 2003;
163(13):
1574 - 1579.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Meune, I. Mahe, J.-J. Mourad, A. Cohen-Solal, B. Levy, J.-P. Kevorkian, G. Jondeau, A. Habib, M. Lebret, A.-L. Knellwolf, et al.
Aspirin alters arterial function in patients with chronic heart failure treated with ACE inhibitors: a dose-mediated deleterious effect
Eur J Heart Fail,
June 1, 2003;
5(3):
271 - 279.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. O. Arnold, S. Yusuf, J. Young, J. Mathew, D. Johnstone, A. Avezum, E. Lonn, J. Pogue, J. Bosch, and on behalf of the HOPE Investigators
Prevention of Heart Failure in Patients in the Heart Outcomes Prevention Evaluation (HOPE) Study
Circulation,
March 11, 2003;
107(9):
1284 - 1290.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K Dubey, D K Balani, and K K Pillai
Potential adverse interaction between aspirin and Lisinopril in hypertensive rats
Human and Experimental Toxicology,
March 1, 2003;
22(3):
143 - 147.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. Echemann, F. Alla, S. Briancon, Y. Juilliere, J.M. Virion, P.M. Mertes, J.P. Villemot, F. Zannad, and EPICAL Investigators
Antithrombotic therapy is associated with better survival in patients with severe heart failure and left ventricular systolic dysfunction (EPICAL study)
Eur J Heart Fail,
October 1, 2002;
4(5):
647 - 654.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V.L. Serebruany, M.E. McKenzie, A.F. Meister, S.Y. Fuzaylov, P.A. Gurbel, D. Atar, W.A. Gattis, and C.M. O'Connor
Whole blood impedance aggregometry for the assessment of platelet function in patients with congestive heart failure (EPCOT Trial)
Eur J Heart Fail,
August 1, 2002;
4(4):
461 - 467.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G.Y.H. Lip and C.R. Gibbs
Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm: a Cochrane systematic review
QJM,
July 1, 2002;
95(7):
461 - 468.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. S. Lauer
Aspirin for Primary Prevention of Coronary Events
N. Engl. J. Med.,
May 9, 2002;
346(19):
1468 - 1474.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. K. Ghali, T. Simon, M. Mary-Krause, C. Funck-Brentano, and P. Jaillon
Sex Differences in the Prognosis of Congestive Heart Failure Response
Circulation,
October 9, 2001;
104
(15):
e81 - e81.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.G.F. Cleland, K. Thygesen, B.F. Uretsky, P. Armstrong, J.D. Horowitz, B. Massie, M. Packer, P.A. Poole-Wilson, L. Ryden, and on behalf of the ATLAS investigators
Cardiovascular critical event pathways for the progression of heart failure; a report from the ATLAS study
Eur. Heart J.,
September 1, 2001;
22(17):
1601 - 1612.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J.M. Cruz-Fernandez
Antiplatelet drugs in the treatment of acute coronary syndromes: Focus on cyclooxygenase inhibitors
Eur. Heart J. Suppl.,
August 1, 2001;
3(suppl_I):
I23 - I30.
[Abstract]
[PDF]
|
|
|
|
|
|
|
R. Isnard and M. Komajda
Thromboembolism in heart failure, old ideas and new challenges
Eur J Heart Fail,
June 1, 2001;
3(3):
265 - 269.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. M. Krumholz, Y.-T. Chen, Y. Wang, and M. J. Radford
Aspirin and Angiotensin-Converting Enzyme Inhibitors Among Elderly Survivors of Hospitalization for an Acute Myocardial Infarction
Arch Intern Med,
February 26, 2001;
161(4):
538 - 544.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. M. Krumholz, Y.-T. Chen, and M. J. Radford
Aspirin and the Treatment of Heart Failure in the Elderly
Arch Intern Med,
February 26, 2001;
161(4):
577 - 582.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Simon, M. Mary-Krause, C. Funck-Brentano, and P. Jaillon
Sex Differences in the Prognosis of Congestive Heart Failure : Results From the Cardiac Insufficiency Bisoprolol Study (CIBIS II)
Circulation,
January 23, 2001;
103(3):
375 - 380.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Patrono, B. Coller, J. E. Dalen, G. A. FitzGerald, V. Fuster, M. Gent, J. Hirsh, and G. Roth
Platelet-Active Drugs : The Relationships Among Dose, Effectiveness, and Side Effects
Chest,
January 1, 2001;
119
(2009):
39S - 63S.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Cairns, P. Theroux, H. D. Lewis Jr., M. Ezekowitz, and T. W. Meade
Antithrombotic Agents in Coronary Artery Disease
Chest,
January 1, 2001;
119
(2009):
228S - 252S.
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Diet and E. Erdmann
Thromboembolism in heart failure: who should be treated?
Eur J Heart Fail,
December 1, 2000;
2(4):
355 - 363.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. D. Frances, H. Noguchi, B. M. Massie, W. S. Browner, and M. McClellan
Are We Inhibited?: Renal Insufficiency Should Not Preclude the Use of ACE Inhibitors for Patients With Myocardial Infarction and Depressed Left Ventricular Function
Arch Intern Med,
September 25, 2000;
160(17):
2645 - 2650.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. F. Uretsky, K. Thygesen, P. W. Armstrong, J. G. Cleland, J. D. Horowitz, B. M. Massie, M. Packer, P. A. Poole-Wilson, and L. Ryden
Acute Coronary Findings at Autopsy in Heart Failure Patients With Sudden Death : Results From the Assessment of Treatment With Lisinopril and Survival (ATLAS) Trial
Circulation,
August 8, 2000;
102(6):
611 - 616.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Stys, W. E. Lawson, G. C. Smaldone, and A. Stys
Does Aspirin Attenuate the Beneficial Effects of Angiotensin-Converting Enzyme Inhibition in Heart Failure?
Arch Intern Med,
May 22, 2000;
160(10):
1409 - 1413.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. H. Awtry and J. Loscalzo
Aspirin
Circulation,
March 14, 2000;
101(10):
1206 - 1218.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. V. Cokkinos and P. K. Toutouzas
Antithrombotic therapy in heart failure: a randomized comparison of warfarin vs. aspirin (HELAS)
Eur J Heart Fail,
December 17, 1999;
1(4):
419 - 423.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Leor, H. Reicher-Reiss, U. Goldbourt, V. Boyko, S. Gottlieb, A. Battler, and S. Behar
Aspirin and mortality in patients treated with angiotensin-converting enzyme inhibitors: A cohort study of 11,575 patients with coronary artery disease
J. Am. Coll. Cardiol.,
June 1, 1999;
33(7):
1920 - 1925.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D.J. van Veldhuisen, A. Charlesworth, H.J.G.M. Crijns, K.I. Lie, and J.R. Hampton
Differences in drug treatment of chronic heart failure between European countries
Eur. Heart J.,
May 1, 1999;
20(9):
666 - 672.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S GALATIUS, H WROBLEWSKI, and J KASTRUP
Erratum.
Heart,
March 1, 1999;
81(3):
330 - 330.
[Full Text]
|
|
|
|
|
|
|
Antiplatelet Agents Prolong Life in Heart Failure Patients
Journal Watch Emergency Medicine,
April 1, 1998;
1998(401):
8 - 8.
[Full Text]
|
|
|
|
|
|
|
Aspirin Improves Survival in Heart Failure
Journal Watch Cardiology,
February 27, 1998;
1998(227):
2 - 2.
[Full Text]
|
|
|
|
