Aspirin in a diabetic retinopathy setting: Insights from NO BLIND study.

Autor: Pafundi PC; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy., Galiero R; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy., Caturano A; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy., Acierno C; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy., de Sio C; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy., Vetrano E; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy., Nevola R; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy., Gelso A; 'Villa Dei Fiori' Hospital, Corso Italia, 157, 80011, Acerra (Naples), Italy., Bono V; IRCCS Fondazione G. B. Bietti, Via Livenza, 3, 00198, Rome, Italy., Costagliola C; University of Molise, Department of Medicine & Health Sciences 'Vincenzo Tiberio', Via Francesco De Sanctis, 1, 86100, Campobasso, Italy., Marfella R; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy., Sardu C; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy., Rinaldi L; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy., Salvatore T; University of Campania 'Luigi Vanvitelli', Department of Precision Medicine, Via de Crecchio, 7, 80138, Naples, Italy., Adinolfi LE; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy., Sasso FC; University of Campania 'Luigi Vanvitelli', Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy. Electronic address: ferdinandocarlo.sasso@unicampania.it.
Jazyk: angličtina
Zdroj: Nutrition, metabolism, and cardiovascular diseases : NMCD [Nutr Metab Cardiovasc Dis] 2020 Sep 24; Vol. 30 (10), pp. 1806-1812. Date of Electronic Publication: 2020 Jun 29.
DOI: 10.1016/j.numecd.2020.06.021
Abstrakt: Background and Aims: Diabetic retinopathy (DR) is the most common microvascular complication of diabetes. Diabetic macroangiopathies, particularly cardiovascular (CV) diseases, seem closely related to diabetes microvascular complications. Aspirin represents the most prescribed compound in CV prevention. Aspirin impact on DR is still object of debate. As it is already recommended among diabetics at high CV risk, aim of this study was to assess a potential relationship between DR and aspirin therapy, in a type 2 diabetes cohort of patients screened through telemedicine.
Methods and Results: NO Blind is a cross-sectional, multicenter, observational study, which involved nine Italian outpatient clinics. Primary endpoint was the assessment of the relationship between aspirin treatment and DR. 2068 patients were enrolled in the study, subsequently split in two subpopulations according to either the presence or absence of DR. Overall, 995 subjects were under aspirin therapy. After adjusting for most common potential confounders, age and gender, aspirin reveals significantly associated with DR (OR: 1.72, 95%CI: 1.58-2.89, p = 0.002) and proliferative DR (PDR) (OR: 1.89, 95%CI: 1.24-2.84, p = 0.003). Association comes lost further adjusting for MACEs (OR: 1.28, 95%CI: 0.85-1.42, p = 0.157) (Model 4) and eGFR (OR: 0.93; 95%CI: 0.71-1.22; p = 0.591) (Model 5).
Conclusion: In this multicenter cross-sectional study including a large sample of outpatients with T2DM, we showed that aspirin was not associated with DR after adjustment for several cardio-metabolic confounders. However, as partially confirmed by our findings, and related to the well-known pro-hemorrhagic effect of aspirin, its use should be individually tailored, even by telemedicine tools.
Competing Interests: Declaration of competing interest None of the authors have any financial/conflicting interest to disclose.
(Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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