Efficacy of oral aspirin in prevention of embolic events in infective endocarditis: A systematic review and meta analysis
Introduction: Infective endocarditis (IE) involves inflammation of the heart's inner lining and valves, leading to complications like embolic events. The role of aspirin in preventing these events is controversial, with concerns about bleeding risk, limiting its use. This meta-analysis evaluate...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | Thrombosis Update |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666572725000112 |
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| author | Jonathan Victor Salazar-Ore Angie Carolina Alonso-Ramírez Gabriela Vanessa Flores-Monar Emily Patricia Solarte-Zabaleta Miguel Ángel Castaneda-Diaz Ada Lizandra Motino-Villanueva Anuj Manish-Kakkad Camila Sanchez-Cruz Ernesto Calderón-Martínez |
| author_facet | Jonathan Victor Salazar-Ore Angie Carolina Alonso-Ramírez Gabriela Vanessa Flores-Monar Emily Patricia Solarte-Zabaleta Miguel Ángel Castaneda-Diaz Ada Lizandra Motino-Villanueva Anuj Manish-Kakkad Camila Sanchez-Cruz Ernesto Calderón-Martínez |
| author_sort | Jonathan Victor Salazar-Ore |
| collection | DOAJ |
| description | Introduction: Infective endocarditis (IE) involves inflammation of the heart's inner lining and valves, leading to complications like embolic events. The role of aspirin in preventing these events is controversial, with concerns about bleeding risk, limiting its use. This meta-analysis evaluates the effectiveness of oral aspirin in preventing embolic events and its adverse outcomes in IE patients. Methods: A systematic search was conducted on July 20, 2024, across PubMed/MEDLINE, Cochrane, Scopus, Web of Science, EMBASE, and CINAHL for studies comparing aspirin to placebo or no treatment. The protocol was registered in PROSPERO (CRD42024573274). Results: Five studies involving 1174 participants were included, with three eligible for meta-analysis due to data limitations. Findings on embolic event incidence were inconsistent: one randomized clinical trial (RCT) excluding prior aspirin therapy (OR 1.62, [0.68–3.86], p = 0.29) and a reanalysis examining long-term use (OR 0.80, [0.36–1.78], p = 0.582) found no significant reduction, while another study reported a possible reduction (OR 0.65, [0.43–0.98], p = 0.04). Bleeding rates trended higher in aspirin groups across two studies, though not statistically significant. Mortality data also varied; one study found higher mortality in aspirin users, while another associated chronic antiplatelet therapy with lower mortality, particularly with early initiation after admission. Conclusion: Aspirin may reduce embolic events in IE, but evidence remains inconclusive due to mixed findings. Aspirin showed a non-significant increase in bleeding risk and mortality, so routine use for embolic prevention in IE is not recommended, highlighting the need for further research to clarify its potential role. |
| format | Article |
| id | doaj-art-c7ae94ea2f3c4685996af9e91d8cc90c |
| institution | Kabale University |
| issn | 2666-5727 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
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| series | Thrombosis Update |
| spelling | doaj-art-c7ae94ea2f3c4685996af9e91d8cc90c2025-08-20T03:30:39ZengElsevierThrombosis Update2666-57272025-06-011910020810.1016/j.tru.2025.100208Efficacy of oral aspirin in prevention of embolic events in infective endocarditis: A systematic review and meta analysisJonathan Victor Salazar-Ore0Angie Carolina Alonso-Ramírez1Gabriela Vanessa Flores-Monar2Emily Patricia Solarte-Zabaleta3Miguel Ángel Castaneda-Diaz4Ada Lizandra Motino-Villanueva5Anuj Manish-Kakkad6Camila Sanchez-Cruz7Ernesto Calderón-Martínez8Universidad de Buenos Aires, Facultad de Ciencias Médicas, Buenos Aires, 1121, ArgentinaPontificia Universidad Javeriana, Facultad de Medicina, Bogotá, 110231, Colombia; Corresponding author. Pontificia Universidad Javeriana, Colombia.Universidad Central del Ecuador, Quito, 170129, EcuadorUniversidad del Zulia, Facultad de Medicina, Maracaibo, 4001, VenezuelaUniversidad de El Salvador, Facultad Multidisciplinaria de Occidente, San Salvador, 01101, El SalvadorUniversidad Católica de Honduras, Tegucigalpa, 11101, HondurasAmerican International Medical University, Gros-Islet, LC01 101, Saint LuciaUniversidad Nacional Autónoma de México, Department of Digital Health, Mexico City, 04510, MexicoUniversidad Nacional Autónoma de México, Department of Digital Health, Mexico City, 04510, Mexico; Corresponding author. Department of Digital Health, Universidad Nacional Autónoma de México, Mexico.Introduction: Infective endocarditis (IE) involves inflammation of the heart's inner lining and valves, leading to complications like embolic events. The role of aspirin in preventing these events is controversial, with concerns about bleeding risk, limiting its use. This meta-analysis evaluates the effectiveness of oral aspirin in preventing embolic events and its adverse outcomes in IE patients. Methods: A systematic search was conducted on July 20, 2024, across PubMed/MEDLINE, Cochrane, Scopus, Web of Science, EMBASE, and CINAHL for studies comparing aspirin to placebo or no treatment. The protocol was registered in PROSPERO (CRD42024573274). Results: Five studies involving 1174 participants were included, with three eligible for meta-analysis due to data limitations. Findings on embolic event incidence were inconsistent: one randomized clinical trial (RCT) excluding prior aspirin therapy (OR 1.62, [0.68–3.86], p = 0.29) and a reanalysis examining long-term use (OR 0.80, [0.36–1.78], p = 0.582) found no significant reduction, while another study reported a possible reduction (OR 0.65, [0.43–0.98], p = 0.04). Bleeding rates trended higher in aspirin groups across two studies, though not statistically significant. Mortality data also varied; one study found higher mortality in aspirin users, while another associated chronic antiplatelet therapy with lower mortality, particularly with early initiation after admission. Conclusion: Aspirin may reduce embolic events in IE, but evidence remains inconclusive due to mixed findings. Aspirin showed a non-significant increase in bleeding risk and mortality, so routine use for embolic prevention in IE is not recommended, highlighting the need for further research to clarify its potential role.http://www.sciencedirect.com/science/article/pii/S2666572725000112Infective endocarditisAspirinEmbolic eventsMortality riskBleeding riskVegetation reduction |
| spellingShingle | Jonathan Victor Salazar-Ore Angie Carolina Alonso-Ramírez Gabriela Vanessa Flores-Monar Emily Patricia Solarte-Zabaleta Miguel Ángel Castaneda-Diaz Ada Lizandra Motino-Villanueva Anuj Manish-Kakkad Camila Sanchez-Cruz Ernesto Calderón-Martínez Efficacy of oral aspirin in prevention of embolic events in infective endocarditis: A systematic review and meta analysis Thrombosis Update Infective endocarditis Aspirin Embolic events Mortality risk Bleeding risk Vegetation reduction |
| title | Efficacy of oral aspirin in prevention of embolic events in infective endocarditis: A systematic review and meta analysis |
| title_full | Efficacy of oral aspirin in prevention of embolic events in infective endocarditis: A systematic review and meta analysis |
| title_fullStr | Efficacy of oral aspirin in prevention of embolic events in infective endocarditis: A systematic review and meta analysis |
| title_full_unstemmed | Efficacy of oral aspirin in prevention of embolic events in infective endocarditis: A systematic review and meta analysis |
| title_short | Efficacy of oral aspirin in prevention of embolic events in infective endocarditis: A systematic review and meta analysis |
| title_sort | efficacy of oral aspirin in prevention of embolic events in infective endocarditis a systematic review and meta analysis |
| topic | Infective endocarditis Aspirin Embolic events Mortality risk Bleeding risk Vegetation reduction |
| url | http://www.sciencedirect.com/science/article/pii/S2666572725000112 |
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