Ácido acetilsalicílico na prevenção primária e o risco de insuficiência cardíaca: uma revisão sistemática e metanálise de ensaios clínicos

Abstract

Reference: Acetylsalicylic acid in primary prevention and the risk of heart failure: a systematic review and meta-analysis of clinical trials. Introduction: Heart failure is a clinical syndrome based on the inability of the heart to pump properly to meet organic demands. Thus, cardiac contraction requires high pressure to be performed, with consequent reduced debt and/or pulmonary or systemic congestion. This characteristic yields a prothrombotic disease profile, and when associated with chronic inflammation, can have negative consequences. Objectives: This study aims to evaluate the relationship between the use of acetylsalicylic acid in primary prevention and the incidence of heart failure through a systematic review, comparing with the results found by Mujaj et al., 2022. Methods: A systematic review with meta-analysis was performed using a random effects model. Randomised clinical trials comparing acetylsalicylic acid users versus non-users and the risk of developing heart failure in both groups were analysed. We also assessed the heterogeneity of the sample using I2 statistic with a 95% confidence interval. The two-tailed P value considered statistically significant was <0.05. Results: In total, 4 randomised controlled trials were included, with 40,418 patients. 2 studies described incident heart failure as an outcome and the other 2 reported hospitalisations for heart failure. We found no association between acetylsalicylic acid use and increased risk of heart failure (OR 0.93; 95% CI 0.77-1.13; P = 0.502; I2 = 5.57%; P=0.494). Conclusion: The results of the study suggest a less than 1% risk of acetylsalicylic acid increasing the chance of developing heart failure. This way, it can be inferred that the clinical association between the two is limited. However, due to the limitations of the study, it is not possible to make any kind of recommendation.