Prehospital aspirin use is associated with improved clinical outcomes in pulmonary embolism: A retrospective case-control study
Author Department
Medicine; Surgery
Document Type
Article, Peer-reviewed
Publication Date
11-2025
Abstract
Background: Pulmonary embolism (PE) is a leading cause of cardiovascular mortality. Although anticoagulation is the cornerstone of treatment, aspirin's potential to modulate thromboinflammation and improve outcomes in non-surgical PE patients remains underexplored.
Aim: To assess whether prehospital aspirin use is associated with improved outcomes in patients hospitalized with acute PE.
Methods: We conducted a retrospective case-control study of 323 adult patients admitted with computed tomography-confirmed acute PE from January 2020 to December 2023. Patients were stratified according to documented daily aspirin use for ≥ 7 days prior to hospital admission. Primary outcomes included right ventricular strain, intensive care admission, shock, mechanical ventilation, and in-hospital mortality. Univariate logistic regression was used. A P value < 0.05 was considered significant.
Results: Total of 323 patients, 90 (27.9%) used aspirin prehospital. Aspirin users were older (74.2 ± 14.3 years vs 66.9 ± 16.7 years, P < 0.001) and had more coronary artery disease. Aspirin use was associated with significantly lower rates of right ventricular strain on computed tomography [22.2% vs 34.8%, odds ratio (OR) = 0.536, 95% confidence interval (CI): 0.305-0.944, P = 0.029], Intensive care admission (16.7% vs 28.8%, OR = 0.496, 95%CI: 0.266-0.924, P = 0.025), shock (2.2% vs 9.9%, OR = 0.208, 95%CI: 0.048-0.899, P = 0.021), and in-hospital mortality (3.3% vs 11.6%, OR = 0.260, 95%CI: 0.080-0.889, P = 0.022).
Conclusion: Prehospital aspirin use is associated with reduced severity and mortality in acute PE. These findings support a potential protective role for aspirin and warrant validation in prospective, multicenter trials.
Keywords: Antiplatelet therapy; Aspirin; Intensive care unit; Mortality; Pulmonary embolism; Right ventricular strain; Shock.
Recommended Citation
Suresh MG, Mohamed S, Shanmugavel Geetha H, Sekar A, Prabhu S, Sargent J, Abraham GM, Hatwal J, Batta A, Mohan B. Prehospital aspirin use is associated with improved clinical outcomes in pulmonary embolism: A retrospective case-control study. World J Cardiol. 2025 Nov 26;17(11):110178. doi: 10.4330/wjc.v17.i11.110178.
PMID
41356593