{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T15:00:25Z","timestamp":1765292425054,"version":"3.46.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,12,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Guidelines recommend aspirin (75\u2013100 mg daily) for the secondary prevention of atherosclerotic cardiovascular disease (ASCVD). However, it is unknown if people with a history of ASCVD and chronic obstructive pulmonary disease (COPD) or asthma, which are independent risk factors for ASCVD, would benefit from higher dose aspirin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We evaluated the effectiveness and safety of 2 aspirin doses among individuals with and without COPD\/asthma in the ADAPTABLE (Aspirin Dosing: A Patient\u2010Centric Trial Assessing Benefits and Long\u2010Term Effectiveness) trial. The ADAPTABLE study was an open\u2010label, randomized clinical trial that assigned people with ASCVD to aspirin 81 or 325 mg. We performed a secondary analysis of data from the ADAPTABLE study to investigate the difference in clinical effectiveness and safety among people with and without COPD or asthma randomized to aspirin 325 versus 81 mg. We assessed if history of COPD\/asthma modified the association between aspirin dose and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among the 14\u2009662 participants, 2778 had a history of COPD or asthma and 11\u2009884 had no history of COPD or asthma. We observed no significant interaction between aspirin dose and history of COPD\/asthma in our adjusted primary composite outcome (adjusted hazard ratio [aHR], 1.15 [95% CI, 0.92\u20131.43];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      value=0.349). We observed individuals with a history of COPD\/asthma treated with aspirin 81 mg had a significantly higher risk of stroke (aHR, 2.41 [95% CI, 1.27\u20134.57]) compared with a treatment strategy of aspirin 325 mg.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among people with ASCVD and COPD\/asthma, there were no significant differences in ASCVD outcomes based on aspirin dosing except stroke. Further evaluation of stroke prevention in this population is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043161","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T12:16:11Z","timestamp":1764159371000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Aspirin Dosing for Secondary Prevention of Atherosclerotic Cardiovascular Disease in Chronic Obstructive Pulmonary Disease and Asthma: Insights From ADAPTABLE"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8463-1947","authenticated-orcid":false,"given":"Christopher L.","family":"Mosher","sequence":"first","affiliation":[{"name":"Duke University School of Medicine","place":["Durham"]},{"name":"Duke Clinical Research Institute","place":["Durham"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0808-9025","authenticated-orcid":false,"given":"Amanda","family":"Stebbins","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute","place":["Durham"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney E.","family":"Lamberton","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine","place":["Durham"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1732-9067","authenticated-orcid":false,"given":"Lisa M.","family":"Wruck","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute","place":["Durham"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3387-9616","authenticated-orcid":false,"given":"Adrian F.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute","place":["Durham"]},{"name":"Duke University School of Medicine","place":["Durham"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8992-6197","authenticated-orcid":false,"given":"Catherine P.","family":"Benziger","sequence":"additional","affiliation":[{"name":"Essentia Health","place":["Duluth"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9544-838X","authenticated-orcid":false,"given":"Jeffrey","family":"Whittle","sequence":"additional","affiliation":[{"name":"Clement J. Zablocki Veterans Affairs Medical Center","place":["Milwaukee"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2440-9033","authenticated-orcid":false,"given":"Kamal","family":"Gupta","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center","place":["Kansas City"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1506-3990","authenticated-orcid":false,"given":"Russell L.","family":"Rothman","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center","place":["Nashville"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4214-7129","authenticated-orcid":false,"given":"Sunil","family":"Kripalani","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center","place":["Nashville"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8644-2827","authenticated-orcid":false,"given":"Ken M.","family":"Kunisaki","sequence":"additional","affiliation":[{"name":"Pulmonary Section, Minneapolis VA Health Care System","place":["Minneapolis"]},{"name":"University of Minnesota","place":["Minneapolis"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6089-366X","authenticated-orcid":false,"given":"Ashraf","family":"Fawzy","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine","place":["Baltimore"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9207-1820","authenticated-orcid":false,"given":"Mark T.","family":"Dransfield","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham","place":["Birmingham"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7288-9596","authenticated-orcid":false,"given":"W. Schuyler","family":"Jones","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute","place":["Durham"]},{"name":"Duke University School of Medicine","place":["Durham"]},{"name":"Duke University School of Medicine","place":["Durham"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-2600(20)30105-3"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00124605"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2012.02.005"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-069679"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201804-0682CI"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00008612"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.08.027"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-2600(23)00261-8"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2023.08.021"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-2600(15)00241-6"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-2847"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0057-2018"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.11.053"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/atvbaha.115.305452"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-019-00562-x"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.14444"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.02.046"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.43621"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2013.05.001"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000056767.69054.b3"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.122.026644"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1613998"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.157529"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2013-203608"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1038\/s44161-022-00067-z"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-11-391532"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.846055"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7329.71"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318235eb4d"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs092"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2102137"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.0116"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7501"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-0749"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-023-02217-0"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2024.1712"},{"key":"e_1_3_2_38_2","unstructured":"National Library of Medicine Value Set Authority Center . Accessed July 2 2024. https:\/\/vsac.nlm.nih.gov\/."},{"key":"e_1_3_2_39_2","unstructured":"Chronic Conditions Data Warehouse . Centers for Medicare & Medicaid Services (CMS). Accessed July 2 2024. https:\/\/www2.ccwdata.org\/web\/guest\/home\/."},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.4437"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202010-1247OC"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.043161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T14:51:55Z","timestamp":1765291915000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.043161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,2]]},"references-count":40,"journal-issue":{"issue":"23","published-print":{"date-parts":[[2025,12,2]]}},"alternative-id":["10.1161\/JAHA.125.043161"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.043161","relation":{},"ISSN":["2047-9980"],"issn-type":[{"type":"electronic","value":"2047-9980"}],"subject":[],"published":{"date-parts":[[2025,12,2]]},"assertion":[{"value":"2025-04-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e043161"}}