Effect of Low-Dose Aspirin Versus Placebo on Incidence of Anemia in the Elderly (vol 176, pg 913, 2023)

被引：0

作者：

McQuilten

机构：

[1] School of Public Health and Preventive Medicine, Monash University, Department of Haematology, Monash Health

[2] Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC

[3] School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC

[4] Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Melbourne, Parkville, VIC

[5] Diagnostic Haematology, The Royal Melbourne Hospital, Parkville, VIC

[6] Clinical Haematology, The Peter MacCallum Cancer Centre, The Royal Melbourne Hospital, Parkville, VIC

[7] Department of Medical Biology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC

[8] City of Hope National Medical Center, Duarte, CA

[9] Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA

[10] Center for the Study of Aging and Human Development, Duke University, Durham, NC

[11] Cancer, Ageing and Vaccines Research Group, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC

[12] Berman Center for Outcomes and Clinical Research, Department of Medicine, Geriatrics Division, Hennepin Healthcare Research Institute, Minneapolis, MN

[13] Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS

[14] School of Public Health and Preventive Medicine, Monash University

[15] Clinical Biochemistry Unit, Alfred Pathology Service, Alfred Health, Melbourne, VIC

[16] School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC

[17] Department of Haematology, Monash Health, Melbourne, VIC

[18] School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Road, Melbourne, 3004, VIC

来源：

ANNALS OF INTERNAL MEDICINE | 2023年 / 176卷 / 09期

基金：

美国国家卫生研究院;

关键词：

D O I：

10.7326/L23-0274

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Daily low-dose aspirin increases major bleeding; however, few studies have investigated its effect on iron deficiency and anemia. Objective: To investigate the effect of low-dose aspirin on incident anemia, hemoglobin, and serum ferritin concentrations. Design: Post hoc analysis of the ASPREE (ASPirin in Reducing Events in the Elderly) randomized controlled trial. (ClinicalTrials. gov: NCT01038583) Setting: Primary/community care in Australia and the United States. Participants: Community-dwelling persons aged 70 years or older (≥65 years for Black persons and Hispanic persons). Intervention: 100 mg of aspirin daily or placebo. Measurements: Hemoglobin concentration was measured annually in all participants. Ferritin was measured at baseline and 3 years after random assignment in a large subset. Results: 19 114 persons were randomly assigned. Anemia incidence in the aspirin and placebo groups was 51.2 events and 42.9 events per 1000 person-years, respectively (hazard ratio, 1.20 [95% CI, 1.12 to 1.29]). Hemoglobin concentrations declined by 3.6 g/L per 5 years in the placebo group and the aspirin group experienced a steeper decline by 0.6 g/L per 5 years (CI, 0.3 to 1.0 g/L). In 7139 participants with ferritin measures at baseline and year 3, the aspirin group had greater prevalence than placebo of ferritin levels less than 45 mg/L at year 3 (465 [13%] vs. 350 [9.8%]) and greater overall decline in ferritin by 11.5% (CI, 9.3% to 13.7%) compared with placebo. A sensitivity analysis quantifying the effect of aspirin in the absence of major bleeding produced similar results. Limitations: Hemoglobin was measured annually. No data were available on causes of anemia. Conclusion: Low-dose aspirin increased incident anemia and decline in ferritin in otherwise healthy older adults, independent of major bleeding. Periodic monitoring of hemoglobin should be considered in older persons on aspirin. © 2023 American College of Physicians. All rights reserved.

引用

页码：1288 / 1288

页数：1