AI Insight
This article presents a pre-registered statistical analysis plan for a sub-study of the ASPREE randomized clinical trial, which investigates whether levels of Lipoprotein(a) (Lp(a)) and related oxidized phospholipids modify the cardiovascular effects of low-dose aspirin in older adults. The study draws on baseline blood samples from 72% of Australian ASPREE participants, with biomarkers including Lp(a), OxPL-apoB, OxPL-apo(a), OxPL-PLG, and plasminogen measured at a specialized laboratory. The analysis plan also incorporates safety endpoints related to major bleeding events, reflecting the dual risk-benefit profile of aspirin therapy.
Why it matters
Identifying which older adults are most likely to benefit from aspirin based on their Lp(a) biology could enable more personalized approaches to cardiovascular primary prevention, potentially reducing unnecessary bleeding risk in those unlikely to benefit. This work is particularly relevant given the declining enthusiasm for universal aspirin use in primary prevention following recent trial results.
⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Lipoprotein(a) (Lp(a)) is associated with atherothrombosis through several mechanisms, including putative antifibrinolytic properties. In the ASPREE randomized trial of daily low-dose aspirin for primary prevention in older adults, 72% of trial participants in Australia provided baseline blood samples from which Lp(a) and related oxidized phospholipids and plasminogen have been measured in a specialized laboratory at University of California San Diego. Recent findings from our group suggest that aspirin may benefit older individuals with genotypes associated with elevated lipoprotein(a). We present an analysis plan to address key hypotheses relating to whether the effects of aspirin on cardiovascular disease might vary based on a person’s measured levels of lipoprotein(a), oxidized phospholipid levels present on protein carriers apoB-100 (OxPL-apoB), Lp(a) (OxPL-apo(a)) and plasminogen (OxPL-PLG), and plasminogen. The analysis plan also articulates safety analyses involving major hemorrhage.