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[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 |
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Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation 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. [Aspirin prescription pattern among diabetic patients for prevention of cardiovascular disease] Seoul: National Evidence-based Healthcare Collaborating Agency (NECA). NECA-A-11-002. 2012 Authors' conclusions 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. Indexing Status Subject indexing assigned by CRD MeSH Aspirins; Cardiovascular Diseases; Diabetes Complications; Diabetes Mellitus Country of organisation South Korea English summary An English language summary is available. Address for correspondence National Evidence-based Healthcare Collaborating Agency (NECA), Changkyung B/D 9F, Wonnam-dong 28-7, Jongno-gu, Seoul, South Korea
Email: hta_neca@neca.re.kr AccessionNumber 32013000657 Date abstract record published 17/09/2013 |
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