{
  "abstract": "ImportanceThe ASPREE randomized trial found no overall benefit of low-dose aspirin for disability-free survival among older adults. However, individual estimates in pre-specified subgroups indicated potential benefit among racial and ethnic minoritized participants in the United States (US).\n\nObjectiveTo evaluate whether the effect of low-dose aspirin vs placebo on disability-free survival differed across US Black and Hispanic ASPREE participants using individualized treatment-effect estimation.\n\nDesign, Setting, and ParticipantsPost hoc clinical trial analysis of ASPREE, a randomized, double-blind, placebo-controlled clinical trial of daily low-dose aspirin vs placebo. This analysis included US ASPREE participants who self-identified as non-Hispanic Black or Hispanic, were aged 65 years or older, and had complete baseline predictor and outcome data.\n\nInterventionsRandomization to daily 100-mg aspirin or placebo.\n\nMain Outcomes and MeasuresThe primary outcome was loss of disability-free survival, defined as death, persistent physical disability, or dementia. Individualized treatment effects were estimated post hoc using a Random Survival Forest X-learner. Heterogeneity was evaluated on the relative scale with Cox proportional hazards models and on the absolute scale with 5-year risk differences.\n\nResultsAmong 2411 US ASPREE participants, 1270 were included in the Black and Hispanic analytic cohort (897 non-Hispanic Black and 373 Hispanic participants; mean age, 71.8 years). Aspirin was associated with lower risk of disability-free survival loss compared with placebo (hazard ratio [HR], 0.65; 95% CI, 0.45-0.93). In model-derived tertiles, aspirin was associated with lower risk in the greatest predicted-benefit group (HR, 0.36; 95% CI, 0.19-0.71; 5-year absolute risk difference [ARD], -11.1 percentage points; 95% CI, -22.0 to -0.1) but not in the lowest predicted-benefit group (HR, 1.26; 95% CI, 0.70-2.27; ARD, +3.9 percentage points; 95% CI, -5.9 to 13.6).\n\nConclusions and RelevanceIn these analyses of US Black and Hispanic ASPREE participants, aspirin effects on disability-free survival appear to be heterogeneous, with benefit concentrated in a subset of participants. Because these findings are from post-hoc models, they should be externally validated before being incorporated into clinical decision-making.\n\nTrial RegistrationClinicalTrials.gov Identifier: NCT01038583; https://clinicaltrials.gov/study/NCT01038583",
  "abstract_shown": true,
  "affiliations": [
    "Rush University Medical Center"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "name": "G. Tzimas"
    },
    {
      "name": "J. C. Vanghelof"
    },
    {
      "name": "A. Mohammed"
    },
    {
      "name": "D. S. Raicu"
    },
    {
      "name": "L. Du"
    },
    {
      "name": "M. E. Ernst"
    },
    {
      "name": "E. T. Warner"
    },
    {
      "name": "A. T. Chan"
    },
    {
      "name": "J. Ryan"
    },
    {
      "name": "S. E. Espinoza"
    },
    {
      "name": "A. Murray"
    },
    {
      "name": "K. Sheets"
    },
    {
      "name": "R. B. Tchoua"
    },
    {
      "affs": [
        0
      ],
      "name": "R. C. Shah"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0nxgw967987tc.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.08.24.26361036",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.08.24.26361036v1.full",
  "id": "0nxgw967987tc",
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  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.08.24.26361036v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "geriatric medicine"
    ],
    [
      "openalex",
      "2705|Antiplatelet Therapy and Cardiovascular Diseases"
    ]
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  "openalex": "W7204470103",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.08.24.26361036v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-24",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/0nxgw967987tc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:27Z",
      "native_id": "10.64898/2026.08.24.26361036",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.08.24.26361036v1"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Antiplatelet Therapy and Cardiovascular Diseases",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Aspirin and healthy longevity within racial and ethnic minoritized older adults in the United States",
  "title_text": "Aspirin and healthy longevity within racial and ethnic minoritized older adults in the United States",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:27Z",
  "url": "https://research.draconitic.com/paper/0nxgw967987tc",
  "venue": "medRxiv",
  "versions": []
}