Prescribing Aspirin for Primary Prevention and Risk Factors of Cardiovascular Events in Diabetic Patients at Huaiyot Hospital, Trang Province
Keywords:
Aspirin, Cardiovascular disease, Primary prevention, Diabetic patientAbstract
Background: Cardiovascular diseases (CVDs), including coronary heart disease and stroke, are a major cause of death in many countries. Currently, using aspirin, an antiplatelet, is recommended to prevent CVDs in diabetic patients but there are still no clear benefits for primary prevention.
Objectives: To compare the incidence of cardiovascular diseases between received aspirin and non-received aspirin groups among diabetic patients without prior CVDs, to identify risk factors for CVD outcomes and to find out the adherence to the American Diabetic Association (ADA) guidelines for aspirin therapy in primary prevention among diabetic patients.
Materials and methods: Retrospective data review was conducted by assessing electrical medical records from January 2012 to 2017. The main interesting risk factors and aspirin used and non-used data were extracted. The outcomes were the new event of CVDs. The processes of data collection and validation following the inclusion and exclusion criteria were performed by the diabetic patient care team. Data analyses were performed by t-test, chi-square test, and multiple logistic regressions.
Results: 1,671 diabetic patients were finally enrolled in the study. Aspirin using increased risk of CVDs, with adjusted OR of 1.16 (95% CI,0.80-1.69), but not statistical significance. Albuminuria, duration of DM more than 10 years and comorbidity with hypertension and dyslipidemia increased the risk of CVDs with adjusted OR of 1.88(95%CI,1.31-2.71), 1.48(95%CI, 1.01-2.25), 3.34 (95%CI,1.75-6.38), 3.89(95%CI,2.00-7.35), respectively. Eighteen point six percent of the subjects were overused aspirin following the ADA recommendation.
Conclusions: The use of low-dose aspirin was likely increased the risk of CVDs in diabetic patients without prior CVDs, but not statistical significance. There is some overuse of aspirin for primary prevention. Doctors should pay attention to other comorbidities such as hypertension and dyslipidemia, especially in a patient with albuminuria and long duration of DM more than 10 years.
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