High Levels of Blood Lactate Associated with the Use of Low Dose Aspirin: A Case-Control Study

We evaluate the risk of severe hyperlactatemia (LA) >4 in patients on chronic treatment with low doses of aspirin (ASP) and estimate the magnitude of the association. For this, a case-crossover study design, where patients who have experienced the outcome (cases) are a part of their controls by containing a period before the onset of the outcome. Additionally, a design based on person-day measurements, rather than individuals, was used for cases and controls. When comparing the group of cases (exposed to ASP/not exposed), we found: 127/578 vs. group controls (ASP exposed/unexposed): 547/3,968, and an OR=1.6 (95% CI:1.29) was obtained (-1.97; z= 4.31; p<0.0001). The risk of lacticaemia greater than 4 mmol/L with the use of low-dose aspirin (100 mg) in its main indication (secondary prophylaxis of vascular ischemic event) appears to be weak (OR=1.6). However, monitoring is recommended when used together with other drugs with the same toxicity profile. Lactate monitoring must be incorporated into an interventional and therapeutic plan so that the patient benefits from these measurements.

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