Does aspirin attenuate the beneficial effect of ACE inhibitors in elderly people with heart failure?
GROUND: Several studies have raised concerns over a possible reduction in the beneficial effects of ACE inhibitors on mortality in people also taking aspirin (acetylsalicylic acid). OBJECTIVE: We performed this study to determine whether there is a reduction in the beneficial effects of ACE inhibitors on mortality in elderly people with heart failure also taking aspirin. PARTICIPANTS: 822 patients discharged from hospital wards with a diagnosis of heart failure participated in the GIFA (Italian Group of Pharmacoepidemiology in the Elderly) study. MEASUREMENTS: We analysed the characteristics of the participants according to the type of therapy prescribed (no ACE inhibitor/no aspirin, ACE inhibitor/no aspirin, no ACE inhibitor/aspirin and ACE inhibitor/aspirin). We calculated the hazard ratios (HRs) for dying associated with each of these treatments, and calculated the synergy index to identify any negative interaction between ACE inhibitor and aspirin. Results: The mean age of study pa
