Aspirin Reduces Cardiovascular Risk in Giant Cell Arteritis: New Findings from EMJ

A new study suggests that initiating low-dose aspirin at the time of giant cell arteritis diagnosis may reduce the risk of major cardiovascular events, though it also increases the likelihood of serious bleeding complications. The findings come from a large population-based cohort study of over 14,000 patients published in JAMA Network Open on April 17, 2026.

Researchers led by Maxime Beydon of Sorbonne Université analyzed data from patients aged 50 and older who were newly diagnosed with giant cell arteritis and had no prior history of cardiovascular disease or use of antiplatelet or anticoagulant medications. Among the 14,528 patients included in the study, 5,220 (36%) began low-dose aspirin therapy within 14 days of their diagnosis.

At one year follow-up, patients who started low-dose aspirin had a significantly lower risk of major adverse cardiovascular events—defined as a composite of ischemic stroke, myocardial infarction and all-cause mortality—compared to those who did not. The relative risk was 0.86, with a 95% confidence interval ranging from 0.75 to 0.96.

All-cause mortality was also lower in the aspirin group at one year. However, the protective cardiovascular effects came with an increased risk of major hemorrhage, particularly gastrointestinal bleeding. The relative risk of major hemorrhage was 1.29, with a 95% confidence interval of 1.05 to 1.53.

The cardiovascular benefits of low-dose aspirin were observed at both one and three years after diagnosis, while the increased bleeding risk was primarily evident during the first year of treatment. Subgroup analyses indicated that the greatest reduction in cardiovascular events occurred among women and patients with diabetes at the time of diagnosis.

For women, the risk difference in major adverse cardiovascular events was −0.78% (95% CI: −1.29% to −0.25%). For patients with diabetes, the risk difference was −2.23% (95% CI: −3.48% to −1.02%). These findings suggest that selective use of aspirin prophylaxis may be most appropriate for individuals with higher baseline cardiovascular risk, provided the bleeding risk is carefully considered.

The study authors emphasize that while low-dose aspirin initiation at giant cell arteritis diagnosis is associated with improved cardiovascular outcomes, the trade-off with bleeding risk necessitates individualized decision-making. They recommend that clinicians weigh factors such as age, sex, diabetes status, and gastrointestinal bleeding risk when considering aspirin use in this population.

This research builds on prior interest in repurposing low-dose aspirin for cardiovascular prevention in autoimmune conditions, though experts caution that the results do not establish causation and should be interpreted within the limitations of an observational study design. Further research, including randomized controlled trials, would be needed to confirm these associations and determine optimal prescribing strategies.