Long-term Aspirin Use Reduces Severity of Acute COPD Exacerbations, Study Reports

Diogo Pinto avatar

by Diogo Pinto |

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COPD and low-dose morphine

The long-term use of aspirin was found to reduce the severity of acute exacerbations in chronic obstructive pulmonary disease (AECOPD), including in-hospital mortality, invasive ventilation use, and hospital length-of-stay (LOS), researchers reported.

The study, “The association of aspirin use with severity of acute exacerbation of chronic obstructive pulmonary disease: a retrospective cohort study,” was published in the journal NPJ Primary Care Respiratory Medicine.

COPD is a chronic inflammatory lung disease characterized by wheezing, shortness of breath, chest tightness, and cough with mucus.

Acute exacerbations of COPD are caused by a viral or bacterial infection or by environmental pollutants, resulting in a sudden worsening of disease symptoms.

Typically, the aggravated symptoms last for several days and range from self-controlling episodes to respiratory failure requiring mechanical ventilation. They may even result in the patient’s death.

Recently, anti-platelet drugs, which were developed to prevent blood clots, were shown to improve clinical outcomes in COPD patients.

Aspirin, developed as an analgesic, was found to be a very effective anti-platetet drug. But little has been known about the effect of these therapies in COPD acute exacerbations.

Researchers at Massachusetts General Hospital investigated the effect of long-term aspirin use on the severity of acute exacerbations in COPD (AECOPD) patients, including in-hospital mortality rate, mechanical ventilation use, and hospital length of stay (LOS0.

The study collected data from more than 20o,000 patients ages 40 and older hospitalized for AECOPD, using the State Inpatient Database (SID) of seven U.S. states. Data was collected for the years 2012 and 2013.

Of the 206,686 patients included in the study, 13,826 (7%) were aspirin users. Aspirin users were found to be older and more likely to have comorbidities, or co-occurring diseases, compared to nonusers of aspirin.

Long-term aspirin users had lower in-hospital mortality rates compared to nonuser patients (1.0% vs. 1.4%), and a lower risk of invasive mechanical ventilation (1.7% vs. 2.6%). Similarly, shorter LOS was observed in aspirin users compared to nonusers (median of three days vs. four days).

The risk of noninvasive positive pressure ventilation — providing air under pressure by a mechanical respirator — was not significantly different between aspirin users and nonusers (7.6% vs. 7.2%).

The researchers suggested that the improved results in AECOPD outcomes in aspirin users may be linked to the anti-inflammatory properties of aspirin, as well as to the prevention of  blood clots or thrombi. Blood clots may accumulate in blood vessels and impede oxygen’s journey to reach tissues, causing tissue damage.

Still, “the nature of aspirin-acute severity association in COPD warrants further investigation,” the researchers wrote.

“In sum, by using a large population-based data set, we found that long-term aspirin users have lower rates of in-hospital mortality and invasive mechanical ventilation use, and shorter LOS,” researchers added.

“Although causal inferences remain premature, in conjunction with the prior studies, aspirin — a widely used and inexpensive medication — may be a potential therapeutic option for patients with COPD,” the team concluded.


Elaine Pollack avatar

Elaine Pollack

Good to know. Does Tylenol also work? And what about the risk for liver damage for long-term users?

Diogo Pinto avatar

Diogo Pinto

Dear Elaine, thank you for your comment. This study focused only on the use of aspirin and not on Tylenol. Also, researchers did not report the effects of long-term consumption of aspirin on the liver.

Gloria Johnson avatar

Gloria Johnson

I was told to get off all asprin related products and was also told to take only Tylenol and that's what I'm doing. I don't think this article is totally correct. When your pulmonary Dr.tell you he's right. In the first Ct, they found an Ulcer and a blood clot and this is when he told me off with the asprin. When I went for the 2nd CT because he had to stretch my throat also, he looked down into my stomach and both ulcer and clot was gone. He gave me some kind of pill for the healing and to help with the stomach so I disagree with some of these statements. Thanks for the vent. <3

Carole Haynes-Curtis avatar

Carole Haynes-Curtis

it would be helpful to know what dose of aspirin they are talking about I currently take a low dose 75 mg a day is this enough please thank you

Diogo Pinto avatar

Diogo Pinto

Dear Carole. Thank you for your comment. You are right, it would be very useful if they provided the doses that patients were taking. Unfortunately, those values are not mentioned in article.

Susan avatar


I was always told that taking Aspirin long term leads to bleeding of the stomach?

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