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; 17(11): 110178 [DOI: 10.4330/wjc.v17.i11.110178]
Corresponding Author of This Article
Akash Batta, MD, Associate Professor, Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana 141001, Punjab, India. akashbatta02@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 26, 2025 (publication date) through Nov 21, 2025
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Cardiology
ISSN
1949-8462
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
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; 17(11): 110178 [DOI: 10.4330/wjc.v17.i11.110178]
World J Cardiol. Nov 26, 2025; 17(11): 110178 Published online Nov 26, 2025. doi: 10.4330/wjc.v17.i11.110178
Prehospital aspirin use is associated with improved clinical outcomes in pulmonary embolism: A retrospective case-control study
Mithil Gowda Suresh, Safia Mohamed, Harinivaas Shanmugavel Geetha, Akshaya Sekar, Sushmita Prabhu, Jennifer Sargent, George M Abraham, Juniali Hatwal, Akash Batta, Bishav Mohan
Mithil Gowda Suresh, Harinivaas Shanmugavel Geetha, Akshaya Sekar, Sushmita Prabhu, Jennifer Sargent, George M Abraham, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Safia Mohamed, Department of Medicine and Surgery, University of Massachusetts Chan Medical School-Baystate Medical Center, Springfield, MA 01199, United States
Juniali Hatwal, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Akash Batta, Bishav Mohan, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Author contributions: Suresh MG, Geetha HS, and Prabhu S contributed equally to study conception, data collection, and initial manuscript drafting; Mohamed S and Sekar A and participated in statistical analysis, chart review, and results interpretation; Sargent J, Abraham GM, Hatwal J, Batta A, and Mohan B supervised the project, provided critical revisions, and approved the final manuscript; and all authors contributed to data interpretation, revised the manuscript critically for important intellectual content, and approved the final version to be submitted.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Saint Vincent Hospital, approval No. IRB#2022-069.
Informed consent statement: The need for informed consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data will be shared on reasonable request by the journals board.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Akash Batta, MD, Associate Professor, Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana 141001, Punjab, India. akashbatta02@gmail.com
Received: June 3, 2025 Revised: June 17, 2025 Accepted: October 21, 2025 Published online: November 26, 2025 Processing time: 174 Days and 23 Hours
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.
Core Tip: In this retrospective case-control study, we demonstrate that patients with pulmonary embolism who were on aspirin prior to hospitalization had significantly lower incidence of right ventricular strain, intensive care unit admission, shock, and mortality. These results suggest a protective role of aspirin in pulmonary embolism pathophysiology and highlight the need for further prospective validation.
