Lack of benefits for prevention of cardiovascular disease with aspirin therapy in type 2 diabetic patients--a longitudinal observational study
| Autor: | Ronald C.W. Ma, Augustine Lui, Sau-chu Chiang, Gary T. Ko, Juliana C.N. Chan, Derek Stewart, Francis K.L. Chan, Alice P. Kong, Wing-Yee So, Peter C.Y. Tong, Wilson Y.S. Leung, Xilin Yang |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_specialty Endocrinology Diabetes and Metabolism Type 2 diabetes Risk Assessment Cohort Studies Risk Factors Internal medicine Diabetes mellitus Clinical endpoint Secondary Prevention Medicine Humans Longitudinal Studies Registries Stroke Aged Original Investigation Aspirin business.industry Absolute risk reduction Middle Aged medicine.disease Primary Prevention Diabetes Mellitus Type 2 lcsh:RC666-701 Cardiovascular Diseases Cohort Female business Cardiology and Cardiovascular Medicine Cohort study medicine.drug Follow-Up Studies |
| Zdroj: | Cardiovascular Diabetology Cardiovascular Diabetology, Vol 8, Iss 1, p 57 (2009) |
| ISSN: | 1475-2840 |
| Popis: | Background The risk-benefit ratio of aspirin therapy in prevention of cardiovascular disease (CVD) remains contentious, especially in type 2 diabetes. This study examined the benefit and harm of low-dose aspirin (daily dose < 300 mg) in patients with type 2 diabetes. Methods This is a longitudinal observational study with primary and secondary prevention cohorts based on history of CVD at enrolment. We compared the occurrence of primary composite (non-fatal myocardial infarction or stroke and vascular death) and secondary endpoints (upper GI bleeding and haemorrhagic stroke) between aspirin users and non-users between January 1995 and July 2005. Results Of the 6,454 patients (mean follow-up: median [IQR]: 4.7 [4.4] years), usage of aspirin was 18% (n = 1,034) in the primary prevention cohort (n = 5731) and 81% (n = 585) in the secondary prevention cohort (n = 723). After adjustment for covariates, in the primary prevention cohort, aspirin use was associated with a hazard-ratio of 2.07 (95% CI: 1.66, 2.59, p < 0.001) for primary endpoint. There was no difference in CVD event rate in the secondary prevention cohort. Overall, aspirin use was associated with a hazard-ratio of 2.2 (1.53, 3.15, p < 0.001) of GI bleeding and 1.71 (1.00, 2.95, p = 0.051) of haemorrhagic stroke. The absolute risk of aspirin-related GI bleeding was 10.7 events per 1,000 person-years of treatment. Conclusion In Chinese type 2 diabetic patients, low dose aspirin was associated with a paradoxical increase in CVD risk in primary prevention and did not confer benefits in secondary prevention. In addition, the risk of GI bleeding in aspirin users was rather high. |
| Databáze: | OpenAIRE |
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