Vasculitis & polymyalgia rheumatica
Low-Dose Aspirin for Cardiovascular Disease Primary Prevention in Patients With Giant Cell Arteritis
Authors' conclusion
In this retrospective cohort study, low-dose aspirin at GCA diagnosis was associated with lower MACE at 1 and 3 years but higher hemorrhage risk at 1 year.
Study context
- Population
- Individuals aged ≥50 years with incident giant cell arteritis (GCA) 2010–2022, without previous cardiovascular events or antiplatelet or anticoagulant use at GCA diagnosis; French National Health Data Systemmedian age 74 years
- Participants
- 14,528 individuals
- Exposure
- Initiation of low-dose aspirin vs not within 14 days of GCA diagnosis
- Low-dose aspirinn = 5,220
- Outcome
- Major adverse cardiovascular events (MACE): composite of ischemic stroke, MI and all-cause mortality
- Follow-up
- 1 year
Methodological detailspopulation-based, target trial emulation, cloning, censoring, and weighting approach
- Population-based
- Target trial emulation
- Cloning, censoring, and weighting approach
Main finding
As reported in the abstract
MACE
Each group vs controlRelative risk (95% CI)
Low-dose aspirin
0.86(0.75–0.96)
Each group vs controlRD (95% CI)
Low-dose aspirin
−0.54%(−0.99% to −0.12%)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | RD (95% CI) | |
|---|---|---|
| All-cause mortality · 1 year | −0.43% (−0.77% to −0.10%) | |
| MACE · 3 years | −1.08% (−1.77% to −0.41%) | |
| MACE in women (subgroup) · 1 year | −0.78% (−1.29% to −0.25%) | |
| MACE in patients with diabetes at GCA diagnosis (subgroup) · 1 year | −2.23% (−3.48% to −1.02%) | |
| −4−202Difference (linear scale) |
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| Major hemorrhage · 1 yearLow-dose aspirinvs Control | 1.29 (1.05–1.53) | |
| 0.512Relative risk (log scale) |
| Outcome | RD (95% CI) | |
|---|---|---|
| Major hemorrhage · 1 yearLow-dose aspirinvs Control | 0.51% (0.13%–0.91%) | |
| −0.500.51Difference (linear scale) |
Major hemorrhage · 3 years
- No difference in major hemorrhages
Original publication
Low-Dose Aspirin for Cardiovascular Disease Primary Prevention in Patients With Giant Cell Arteritis. JAMA Netw Open. Published 1 April 2026. doi:10.
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