Abstract
Introduction: ST-elevation myocardial infarction (STEMI) causes myocardial ischemic necrosis. Aspirin is recommended in acute coronary syndromes, but prior use has been paradoxically linked to worse outcomes in some reports. We investigated whether prior aspirin use is associated with right ventricular (RV) systolic and diastolic function assessed by echocardiography in STEMI patients.
Methods: In this cross-sectional study over 1.5 years, 210 consecutive STEMI patients undergoing primary percutaneous coronary intervention at Bu-Ali Sina Hospital (Qazvin) and Tehran Heart Center were enrolled. A history of aspirin use (typically low-dose 81 mg daily for at least 7 days prior) was documented. Demographic, clinical, and medication data were recorded. Transthoracic echocardiography was performed before discharge. Key RV parameters including tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC), tissue Doppler S′, and tricuspid inflow velocities were measured. Data were analyzed using t-tests, chi-square tests, and multivariate linear regression adjusting for age, hypertension, diabetes, sex, and body mass index.
Results: Of 210 patients (mean age 58.3±11.6 years, 79% male), 36 (17.1%) had prior aspirin use. Aspirin users were older (62.4±10.5 vs. 57.5±11.7 years, P=0.019) with higher rates of hypertension and diabetes. Univariate analysis showed no significant differences in RV parameters. After multivariate adjustment, prior aspirin use was associated with better RVFAC (+3.69%, P=0.137).
Conclusion: Prior aspirin use was associated with better RV systolic function after adjustment for confounders, although causality cannot be inferred from this observational study.