Progression of Emphysema With Regular Aspirin Use
Additional studies examining aspirin and platelet activation in patients with emphysema are warranted.
Regular use of aspirin is associated with a slower progression in the percent of emphysema-like lung on computed tomography (CT) scans over 10 years, according to the results of a recent prospective cohort study — the Multi-Ethnic Study of Atherosclerosis (MESA) — conducted from 2000 to 2002 in 6 US communities and published in Chest.
The participants enrolled in the MESA Lung Study were between aged 45 and 84 years with no evidence of clinical cardiovascular disease between the years 2000 and 2002. The MESA Lung Study evaluated the percentage of emphysema-like lung below –950 Hounsfield units (termed “percent emphysema”) based on cardiac CTs (2000 to 2007) and full-lung CTs (2010 to 2012). Regular aspirin use was defined as at least 3 days per week.
A total of 4257 participants were eligible for study enrollment. Of these, 926 individuals (22%) were taking aspirin regularly at baseline and 3331 participants (78%) were not taking aspirin at baseline. Mean participant age was 61±10 years, 49% were men, and 54% were ever-smokers.
The mean increase in percent emphysema was 0.60 percentage points over 10 years of follow-up (95% CI, 0.30-0.90; P <.001). The progression of percent emphysema was slower in regular aspirin users than in non-aspirin users (fully adjusted analysis: –0.34 percentage points over 10 years; 95% CI, –0.60 to –0.08; P =.011). Similar results were reported in ever-smokers, as well as in participants taking low-dose aspirin (81 mg) or full-strength aspirin (300 mg to 325 mg). Results were of a higher magnitude in participants with airflow limitation. No relationship was observed between aspirin use and change in lung function.
The investigators concluded that additional studies of aspirin and platelet activation in patients with emphysema are warranted.
Disclosures: Dr Hoffman is a founder and shareholder of VIDA Diagnostics, a company commercializing lung image analysis software developed in part at the University of Iowa, and Dr Austin has received personal fees from PulmonX.
Aaron CP, Schwartz JE, Hoffman EA, et al. A longitudinal cohort study of aspirin use and progression of emphysema-like lung on CT: the MESA Lung Study [published online December 12, 2017]. Chest. doi:10.1016/j.chest.2017.11.031