Low-doses aspirin in the primary prevention of cardiovascular disease in patients with diabetes: Meta-analysis stratified by baseline cardiovascular risk

2022 ◽  
pp. 102391
Author(s):  
Walter Masson ◽  
Leandro Barbagelata ◽  
Augusto Lavalle-Cobo ◽  
Martín Lobo ◽  
Gerardo Masson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
Meta Analysis ◽  
Low Doses ◽  
Patients With Diabetes ◽  
Prevention Of Cardiovascular Disease

scholarly journals Aspirin for primary prevention of cardiovascular outcomes in diabetes mellitus: An updated systematic review and meta-analysis

2019 ◽  
Vol 27 (19) ◽  
pp. 2034-2041 ◽  
Author(s):  
Safi U Khan ◽  
Zain Ul Abideen Asad ◽  
Muhammad U Khan ◽  
Swapna Talluri ◽  
Farman Ali ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Meta Analysis ◽  
Cardiovascular Outcomes ◽  
Randomized Controlled ◽  
Patients With Diabetes ◽  
Incident Cases ◽  
Risk Ratios ◽  
Prevention Of Cardiovascular Disease

Background The safety and efficacy of aspirin for the primary prevention of cardiovascular disease in patients with diabetes mellitus remains controversial. Design A meta-analysis to investigate the effects of aspirin for the prevention of cardiovascular disease in diabetes mellitus. Methods Ten randomized controlled trials were selected using MEDLINE, EMBASE and CENTRAL databases until 27 September 2018. Risk ratios (RRs) with 95% confidence intervals (CIs) and risk differences (RDs) reported as incident events per 1000 person-years were calculated. Results In 33,679 patients, aspirin did not significantly reduce the risk of major adverse cardiovascular outcomes (RR 0.93, 95% CI 0.87–1.00, P = 0.06; RD −0.68 incident cases per 1000 person-years (95% CI −1.54, 0.17)), cardiovascular mortality (RR 0.95, 95% CI 0.83–1.09, P = 0.49; RD 0.11 incident cases per 1000 person-years (95% CI −0.80, 1.02)), myocardial infarction (RR 0.91, 95% CI 0.75–1.11, P = 0.36; RD −0.66 incident cases per 1000 person-years (95% CI −2.07, 0.75)), or stroke (RR 0.91, 95% C, 0.76–1.10, P = 0.33; RD −0.55 incident cases per 1000 person-years (95% CI −1.57, 0.47)). There was a significantly higher risk of total bleeding associated with aspirin (RR 1.29, 95% CI 1.07–1.55, P = 0.01; RD 1.49 incident cases per 1000 person-years (95% CI 0.36, 2.61)). Conclusion The use of aspirin for primary prevention of cardiovascular disease in patients with diabetes mellitus increases the risk of total bleeding without reducing the risk of major adverse cardiovascular outcomes.

Primum non nocere: An updated meta-analysis on aspirin use in primary prevention of cardiovascular disease in patients with diabetes

2019 ◽  
Vol 26 (15) ◽  
pp. 1677-1679 ◽  
Author(s):  
Federico Fortuni ◽  
Gabriele Crimi ◽  
Valeria Gritti ◽  
Alessandro Mandurino Mirizzi ◽  
Sergio Leonardi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Meta Analysis ◽  
Patients With Diabetes ◽  
Prevention Of Cardiovascular Disease

American College of Cardiology and American Heart Association: guideline on the primary prevention of cardiovascular disease

2020 ◽  
Vol 15 (6) ◽  
pp. 1-6
Author(s):  
Belinda Linden
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
American Heart Association Guideline ◽  
Cardiovascular Nursing ◽  
Prevention Of Cardiovascular Disease

Belinda Linden presents a quarterly overview of recently published guidance of relevance to cardiovascular nursing. A guideline on reducing cardiovascular risk through primary prevention in adults is reviewed in this update.

scholarly journals The Efficacy And Safety Of Aspirin As The Primary Prevention Of Cardiovascular Disease: An Updated Meta-Analysis

2019 ◽  
Vol Volume 15 ◽  
pp. 1129-1140 ◽  
Author(s):  
Wenchao Xie ◽  
Ying Luo ◽  
Xiangwen Liang ◽  
Zhihai Lin ◽  
Zhengdong Wang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Prevention Of Cardiovascular Disease

scholarly journals Role of Aspirin for primary prevention of cardiovascular and all-cause mortality events in diabetes: An updated meta-analysis of randomized controlled trials.

2021 ◽  
Author(s):  
Hua Ma ◽  
QIng Gu ◽  
Huining Niu ◽  
Xiaohua Li ◽  
Rong Wang
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Meta Analysis ◽  
Significant Risk ◽  
Diabetic Patients ◽  
Primary Endpoints ◽  
All Cause Mortality ◽  
Patients With Diabetes ◽  
Rule Out

Background: The use of Aspirin in the primary prevention of cardiovascular disease (CVD) is still a topic of debate, especially in patients with diabetes. The present meta-analysis aims to rule out the efficacy of Aspirin in patients with diabetes and to compare the effectiveness of Aspirin with a placebo (or no treatment) for the primary prevention of CVD and all-cause mortality events in people with diabetes. Materials and Methods: An extensive and systematic search was conducted in Medline (via PubMed), Cinahl (via Ebsco), Scopus, and Web of Sciences from 1988 to December 2020. A detailed literature search was conducted using Aspirin, cardiovascular disease (CVD), diabetes, and efficacy to identify trials of patients with diabetes who received Aspirin for primary prevention of CVD. Demographic details with the primary outcome of events and bleeding outcomes were analyzed. The risk of bias (RoB) in included studies was evaluated using the QUADAS-2 tool. Results: A total of 5 studies out of 13 were included with 23,570 diabetic patients; 11,738 allocated to Aspirin and 11,832 allocated to the placebo group. In patients with diabetes, there was no difference between Aspirin and placebo with respect to the risk of all-cause death with a confidence interval (CI) varying 0.63 to 1.17. In addition, there were no differences in the bleeding outcomes with an odds ratio of 1.4411 (CI 0.47 to 4.34). Conclusion: Aspirin has no significant risk on primary endpoints of cardiovascular events and the bleeding outcomes in diabetic patients compared to placebo. More research on the use of Aspirin alone or in combination with other antiplatelet drugs is required in patients with diabetes to supplement currently available research.

Statins for Primary Prevention of Cardiovascular Disease in Elderly Patients: Systematic Review and Meta-Analysis

Drugs & Aging ◽  
2015 ◽  
Vol 32 (8) ◽  
pp. 649-661 ◽  
Author(s):  
Monica Teng ◽  
Liang Lin ◽  
Ying Jiao Zhao ◽  
Ai Leng Khoo ◽  
Barry R. Davis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Elderly Patients ◽  
Meta Analysis ◽  
Prevention Of Cardiovascular Disease

scholarly journals Cross-sectional analysis of the prevalence and predictors of statin utilisation in Ireland with a focus on primary prevention of cardiovascular disease

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018524 ◽  
Author(s):  
Paula Byrne ◽  
John Cullinan ◽  
Catríona Murphy ◽  
Susan M Smith
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
Sociodemographic Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
History Of ◽  
Base Category ◽  
Sectional Analysis ◽  
Prevention Of Cardiovascular Disease

ObjectiveTo describe the prevalence of statin utilisation by people aged over 50 years in Ireland and the factors associated with the likelihood of using a statin, focusing particularly on those using statins for primary prevention of cardiovascular disease (CVD).MethodsThis is a cross-sectional analysis of cardiovascular risk and sociodemographic factors associated with statin utilisation from wave 1 of The Irish Longitudinal Study on Ageing. A hierarchy of indications for statin utilisation, consisting of eight mutually exclusive levels of CVD-related diagnoses, was created. Participants were assigned one level of indication. The prevalence of statin utilisation was calculated. The likelihood that an individual was using a statin was estimated using a multivariable logistic regression model, controlling for cardiovascular risk and sociodemographic factors.ResultsIn this nationally representative sample (n=5618) of community-dwelling participants aged 50 years and over, 1715 (30.5%) were taking statins. Of these, 65.0% (57.3% of men and 72.7% of women) were doing so for the primary prevention of CVD. Thus, almost two-thirds of those taking statins did so for primary prevention and there was a notable difference between women and men in this regard. We also found that statin utilisation was highest among those with a prior history of CVD and was significantly associated with age (compared with the base category 50–64 years; 65–74 years OR 1.38 (95% CI 1.16 to 1.65); 75+ OR 1.33 (95% CI 1.04 to 1.69)), living with a spouse or partner (compared with the base category living alone; OR 1.35 (95% CI 1.10 to 1.65)), polypharmacy (OR 1.74 (95% CI 1.39 to 2.19)) and frequency of general practitioner visits (compared with the base category 0 visits per year; 1–2 visits OR 2.46 (95% CI 1.80 to 3.35); 3–4 visits OR 3.24 (95% CI 2.34 to 4.47); 5–6 visits OR 2.98 (95% CI 2.08 to 4.26); 7+ visits OR 2.51 (95% CI 1.73 to 3.63)), even after controlling for clinical need. There was no association between using statins and gender, education, income, social class, health insurance status, location or Systematic Coronary Risk Evaluation (SCORE) risk in the multivariable analysis.ConclusionStatin utilisation among those with no history of CVD accounted for almost two-thirds of all statin use, in part reflecting the high proportion of the population with no history of CVD, although utilisation rates were highest among those with a history of CVD.

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