Aspirin use and the risk for cardiovascular disease by lipoprotein(a) levels: a multi-cohort study
Authors' conclusion
There was no evidence to suggest that the association between aspirin and the incidence of CVD may differ by lipoprotein(a) levels.
Study context
- Population
- Adults without cardiovascular disease (CVD) in the ARIC, CHS and MESA cohorts; high lipoprotein(a) ≥50 mg/dLARIC 13,085
- Comparison
- Aspirin use vs no aspirin use, by lipoprotein level
- Outcome
- CVD (MI, stroke or CVD death), by high vs low lipoprotein(a)
Methodological detailsmulticohort, propensity-score matched, mixed-effects models, Follow-up through 2018 in ARIC, 2011 in CHS and 2015 in MESA
- Multicohort
- Propensity-score matched
- Mixed-effects models
- Follow-up through 2018 in ARIC, 2011 in CHS and 2015 in MESA
Pooled result
As reported in the abstract
CVD, by lipoprotein(a) (subgroup analysis)
Aspirin use vs No aspirin useHazard ratio (95% CI)
High lipoprotein(a)
1.12(0.96–1.31)
Low lipoprotein(a)
1.04(0.96–1.13)
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| CHD (MI or CHD death), by lipoprotein(a)Aspirin usevs No aspirin useHigh lipoprotein(a) | 1.01 (0.82–1.23) | |
| CHD (MI or CHD death), by lipoprotein(a)Aspirin usevs No aspirin useLow lipoprotein(a) | 1.02 (0.92–1.13) | |
| 0.512Hazard ratio (log scale) |
- Coronary heart disease (CHD) (MI or CHD death), by lipoprotein(a): p-value comparing HRs: 0.94
Aspirin use prevalence
- ARIC
- 25.1%
- CHS
- 29.6%
- MESA
- 19.3%
CVD in further subgroup analyses
- No evidence of an association of aspirin use with lower CVD risk in high or low lipoprotein(a)
Original publication
Aspirin use and the risk for cardiovascular disease by lipoprotein(a) levels: a multi-cohort study. Eur J Prev Cardiol. Published 28 August 2025. doi:10.
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