5-years Follow-up after Primary Prevention of Cardiovascular Events with Aspirin in Patients with Type II Diabetes Mellitus
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Published:
Jun 24, 2019
Keywords:
aspirin type II diabetes mellitus cardiovascular events
Main Article Content
Abstract
Objective: To evaluate the use of aspirin as a primary prevention of cardiovascular events among patients with type II diabetes and to identify the incidence of gastro-intestinal adverse reactions from aspirin. Methods: This study was a retrospective cohort study collecting the data in Mahasarakham hospital from January 1, 2009 through December 31, 2016. Each cohort was followed up for at least 5 years. There were 1,302 eligible patients enrolled into the study with 762 patients (58.53%) receiving aspirin and 540 patients (41.47%) not receiving the drug. Results: Aspirin use in type II diabetic patients was not statistically significant in reducing cardiovascular events including total cardiovascular events (HR 1.00, 95% CI; 0.89-1.11), myocardial infarction (HR 1.00, 95% CI; 0.90-1.12), strokes (HR 1.00, 95% CI; 0.90-1.12) and ischemic heart disease (HR 0.99, 95% CI; 0.89-1.11). In addition, aspirin use did not increase risk of bleeding. Conclusion: Using aspirin in type II diabetic patients shows no beneficial effects on reduction of the risk of cardiovascular disease. However, further studies are in need to confirm the results in Thai population.
Article Details
Section
Research Articles
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
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17. Zhang C, Sun A, Zhang P, Wu C, Zhang S, Fu M, et al. Aspirin for primary prevention of cardiovascular events in patients with diabetes: A meta-analysis. Diabetes Res Clin Pract 2010;87:211-8.
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22. Grundy SM. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Circulation 2002; 106: 3143-421.
23. Stehouwer CD, Smulders YM. Microalbuminuria and risk for cardiovascular disease: analysis of potential mechanisms. J Am Soc Nephrol 2006;17: 2106 -11.
24. Saito Y, Okada S2, Ogawa H, Soejima H, Sakuma M, Nakayama M, et al. Low-dose aspirin for primary prevention of cardiovascular events in patients with type 2 diabetes mellitus 10-year follow-up of a randomized controlled trial. Circulation 2017; 135: 659–70
25. Guirguis-Blake JM, Evans CV, Senger CA, O'Connor EA, Whitlock EP. Evidence summary: aspirin use to prevent cardiovascular events. [online]. 2016 [cited Feb 10, 2016]. Available from: www.uspreventiveser vicestaskforce.org/Page/Document/evidence-summ ary-aspirin-to-prevent-cardiovascular/aspirin-to-prev ent-cardiovascular-disease-and-cancer.
26. Ferreiro JL, Angiolillo DJ. Diabetes and antiplatelet therapy in acute coronary syndrome. Circulation. 2011;123: 798-813.
27. Ertugrul DT, Tutal E, Yildiz M, Akin O, Yalçin AA, Ure OS, et al. Aspirin resistance is associated with glycemic control, the dose of aspirin, and obesity in type 2 diabetes mellitus. J Clin Endocrinol Metab 2010; 95: 2897-901.
28. Bethel MA, Harrison P, Sourij H, Sun Y, Tucker L, Kennedy I, et al. Randomized controlled trial com paring impact on platelet reactivity of twice-daily with once-daily aspirin in people with Type 2 diabetes. Diabet Med 2016; 33: 224-30.
29. Kim YJ, Choi NK, Kim MS, Lee J, Chang Y, Seong JM, et al. Evaluation of low-dose aspirin for primary prevention of ischemic stroke among patients with diabetes: a retrospective cohort study. Diabetol Metab Syndr 2015; 7:8.
30. Okada S, Morimoto T, Ogawa H, Sakuma M, Soejima H, Nakayama M, et al. Effect of low-dose aspirin on primary prevention of cardiovascular events in Japanese diabetic patients at high risk. Circ J 2013; 77: 3023-8.
31. Belch J, MacCuish A, Campbell I, Cobbe S, Taylor R, Prescott R, et al. The Prevention of Progression of Arterial Disease and Diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. BMJ 2008; 337: a1840.
32. Ogawa H, Nakayama M, Morimoto T, Uemura S, Kanauchi M, Doi N, et al. Low-dose aspirin for primary prevention of atherosclerotic events in patients with type 2 diabetes: a randomized controlled trial. JAMA. 2008; 300: 2134-41.
33. Thongbai T. The Prevalence of gastroduodenal mucosal injuries in aspirin users. J Med Assoc Thai 2013; 96 : 1423-7.
34. Mo C, Sun G, Lu ML, Zhang L, Wang YZ, Sun X, et al. Proton pump inhibitors in prevention of low-dose aspirin-associated upper gastrointestinal injuries. World J Gastroenterol 2015;21: 5382-92.
2. Diabetes Association of Thailand. Diabetes Incidence [online]. 2015 [cited Oct 6, 2017]. Available from: www.dmthai.org/news_and_knowledge/1300.
3. Strategy and Planning Division, Ministry of Public Health. Number and rate of diabetes patients per 100,000 populations from 2007 to 2015. [online]. 2015 [cited Oct 6, 2016]. Available from: www.thaincd.com/information-statistic/non-communicable-disease-data.php
4. Permngaam K. Diabetes mellitus [online]. 2011 [cited Jan 25, 2016]. Available from: allied.tu.ac.th/ MedicalTechnology/Documents/Articles/Articles_mt_ gen_KanyanatP_2554_06_29.pdf
5. Arbsuwan N, Panthrawet N. World diabetes day campaign about topic of diabetes 2014 (Fiscal year 2015). [online]. 2014 [cited Jan 25, 2015]. Available from: www.thaincd.com/document /hot%20news/ ประเด็นเบาหวาน58.doc.
6. Khoury JC, Kleindorfer D, Alwell K, Moonmaw CJ, Woo D, Adeoye O, et al. Diabetes mellitus: a risk factor for ischemic stroke in a large bi-racial population. Stroke 2013; 44: 1500-4.
7. International Diabetes Federation. Complications of diabetes [online] 2016. [cited Feb10, 2016]. Available from: www.diabetes.org/complications-diabetes.
8. Ngarmukos C, Bunnag P, Kosachunhanun N, Krittiyawong S, Leelawatana R, Prathipanawatr T, et al. Thailand diabetes registry project: prevalence, characteristics and treatment of patients with diabetic nephropathy. J Med Assoc Thai 2006; 89: S 37-42.
9. Rao Kondapally Seshasai S, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, Sarwar N, et al. Diabetes mellitus fasting glucose and risk of cause-specific death. N Engl J Med. 2011; 364: 829-41.
10. Pratipanawatr T, Rawdaree P, Chetthakul T, Bunnag P, Ngarmukos C, Benjasuratwong Y, et al. Thailand Diabetes Registry Cohort: predicting death in Thai diabetic patients and causes of death. J Med Ass Thailand, 2010; 93:S12-20.
11. American Diabetes Association. Standards of medical care in diabetes–2019. Diabetes care. 2017; 40. [online]. 2019 [cited Jan 9, 2009]. Available from: care.diabetesJournals.org/content/ 42/Supplement_1/S90
12. Bunmak W. Aspirin [online]. 2014. [cite Jan 25, 2015]. Available from: www.pharmacy.mahidol.ac.th/th/ know ledge/article/257/แอสไพริน(aspirin).
13. Whitlock EP, Burda BU, Williams SB, Guirguis-Blake JM, Evans CV. Bleeding risks with aspirin use for primary prevention in adults: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2016; 164: 826-35.
14. Xie M, Shan Z, Zhang Y, Chen S, Yang W, Bao W, et al. Aspirin for primary prevention of cardiovascular events : meta-analysis of randomized controlled trials and subgroup analysis by sex and diabetes status. Plos one 2014; 9: 1-6.
15. Baigent C, Blackwell L, Collins R, Emberson J, Godwin J, Peto R, et al. Aspirin in the primary and secondary prevention of vascular disease: collabora- tive meta-analysis of individual participant data from randomised trials. Lancet 2009;373:1849-60.
16. Butalia S, Leung AA, Ghali WA, Rabi DM. Aspirin effect on the incidence of major adverse cardiovascu lar events in patients with diabetes mellitus: a systematic review and meta analysis. Cardiovasc Diabetol 2011;10: 25.
17. Zhang C, Sun A, Zhang P, Wu C, Zhang S, Fu M, et al. Aspirin for primary prevention of cardiovascular events in patients with diabetes: A meta-analysis. Diabetes Res Clin Pract 2010;87:211-8.
18. De Berardis G, Sacco M, Strippoli GF, Pellegrini F, Graziano G, Tognoni G, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomised controlled trials. BMJ 2009; 339: 4531.
19. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes 2019.[online]. 2019 [cited Jan 10, 2019]. Available from: care.dia betesjournals.org/content/42/Supplement_1/S103.long
20. V. Kasiulevičius ea. Sample size calculation in epidemiological studies. [online]. 2006 [cited Feb 10, 2018]. Available from: www.gerontologija.lt/files/edit _files/File/pdf/2006/nr_4/2006_225_231.pdf
21. Kim YJ, Choi NK, Kim MS, Lee J, Chang Y, Seong JM, et al. Evaluation of low-dose aspirin for primary prevention of ischemic stroke among patients with diabetes: a retrospective cohort study. Diabetol Metab Syndr 2015; 7:8. doi: 10.1186/s13098-015-0002-y.
22. Grundy SM. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Circulation 2002; 106: 3143-421.
23. Stehouwer CD, Smulders YM. Microalbuminuria and risk for cardiovascular disease: analysis of potential mechanisms. J Am Soc Nephrol 2006;17: 2106 -11.
24. Saito Y, Okada S2, Ogawa H, Soejima H, Sakuma M, Nakayama M, et al. Low-dose aspirin for primary prevention of cardiovascular events in patients with type 2 diabetes mellitus 10-year follow-up of a randomized controlled trial. Circulation 2017; 135: 659–70
25. Guirguis-Blake JM, Evans CV, Senger CA, O'Connor EA, Whitlock EP. Evidence summary: aspirin use to prevent cardiovascular events. [online]. 2016 [cited Feb 10, 2016]. Available from: www.uspreventiveser vicestaskforce.org/Page/Document/evidence-summ ary-aspirin-to-prevent-cardiovascular/aspirin-to-prev ent-cardiovascular-disease-and-cancer.
26. Ferreiro JL, Angiolillo DJ. Diabetes and antiplatelet therapy in acute coronary syndrome. Circulation. 2011;123: 798-813.
27. Ertugrul DT, Tutal E, Yildiz M, Akin O, Yalçin AA, Ure OS, et al. Aspirin resistance is associated with glycemic control, the dose of aspirin, and obesity in type 2 diabetes mellitus. J Clin Endocrinol Metab 2010; 95: 2897-901.
28. Bethel MA, Harrison P, Sourij H, Sun Y, Tucker L, Kennedy I, et al. Randomized controlled trial com paring impact on platelet reactivity of twice-daily with once-daily aspirin in people with Type 2 diabetes. Diabet Med 2016; 33: 224-30.
29. Kim YJ, Choi NK, Kim MS, Lee J, Chang Y, Seong JM, et al. Evaluation of low-dose aspirin for primary prevention of ischemic stroke among patients with diabetes: a retrospective cohort study. Diabetol Metab Syndr 2015; 7:8.
30. Okada S, Morimoto T, Ogawa H, Sakuma M, Soejima H, Nakayama M, et al. Effect of low-dose aspirin on primary prevention of cardiovascular events in Japanese diabetic patients at high risk. Circ J 2013; 77: 3023-8.
31. Belch J, MacCuish A, Campbell I, Cobbe S, Taylor R, Prescott R, et al. The Prevention of Progression of Arterial Disease and Diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. BMJ 2008; 337: a1840.
32. Ogawa H, Nakayama M, Morimoto T, Uemura S, Kanauchi M, Doi N, et al. Low-dose aspirin for primary prevention of atherosclerotic events in patients with type 2 diabetes: a randomized controlled trial. JAMA. 2008; 300: 2134-41.
33. Thongbai T. The Prevalence of gastroduodenal mucosal injuries in aspirin users. J Med Assoc Thai 2013; 96 : 1423-7.
34. Mo C, Sun G, Lu ML, Zhang L, Wang YZ, Sun X, et al. Proton pump inhibitors in prevention of low-dose aspirin-associated upper gastrointestinal injuries. World J Gastroenterol 2015;21: 5382-92.
