[Aspirin prescription pattern among diabetic patients for prevention of cardiovascular disease]

Park BJ, Park YS, Choi NK, Lee YJ, Kim MS, Lee CW, Kang DY, Park SY, Park JE, Lee NR, Shin JY, Sung JM, Kim SM, Yang BR, Kim HM, Ahn HJ, Kim JY, Go YJ
Record ID 32013000657
Korean
Original Title: 당뇨병 환자에서 심혈관계질환 발생 예방을 위한 아스피린 사용양상 분석
Authors' recommendations: This study shows no significant benefit of aspirin therapy for the primary prevention of cardiovascular disease in a propensity-score (Ed note: consider edit) matched cohort consisting of incident diabetic patients (HR=1.40; 95% CI, 1.29-1.52). The risk of coronary arterial disease and ischemic stroke, as well as aspirin versus no aspirin (Ed note: placement of 'and' and comma is awkward and leads to confusion; clarify- consider edit)) were 1.74 (95% CI, 1.54-1.96) and 1.14 (95% CI, 1.02-1.28), respectively. The attributable risk of aspirin use for CVDs was 17.5%. The risk of cardiovascular thrombotic events, including myocardial infarction, ischemic stroke, and transient ischemic accident, had also increased by 34% (95% CI, 1.18-1.52). Besides, the hazard ratio for gastrointestinal bleeding, which is a well-known adverse reaction of aspirin significantly increased (HR=1.14; 95% CI, 1.09-1.19). In this study of diabetic patients, low aspirin use did not decrease the risk of CVD events, although it did control for potential confounding. The possible interaction between DM and mechanism of aspirin resulted in reduced anti-thrombotic effect and increased CVD risk for DM patients. In addition, low dose aspirin use was associated with increased risk of bleeding events. Further studies are needed to confirm these findings to assess long term follow-up data and to collect unmeasured confounding factors. It may provide evidence for revising clinical guidelines that recommend cautious usage of low dose aspirin to prevent CVDs in incident diabetic patients.
Details
Project Status: Completed
Year Published: 2012
URL for published report: https://www.neca.re.kr/lay1/program/S1T11C145/report/view.do?seq=120
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: South Korea
MeSH Terms
  • Cardiovascular Diseases
  • Diabetes Complications
  • Diabetes Mellitus
Contact
Organisation Name: National Evidence-based healthcare Collaborating Agency
Contact Address: National Evidence-based Healthcare Collaborating Agency (NECA), 3~5F Health and Welfare Social Administration B/D, 400 Neungdong-ro, Gwangjin-gu, Seoul, Korea.
Contact Name: int@neca.re.kr
Contact Email: int@neca.re.kr
Copyright: National Evidence-based Healthcare Collaborating Agency (NECA)
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