Evaluating factors that influence statin prescribing for primary prevention of atherosclerotic cardiovascular disease in patients with diabetes in an hiv practice setting

2017 ◽  
Vol 13 (4) ◽  
pp. e27
Author(s):  
Laura Fields ◽  
Isabella Villegas ◽  
Sau-Hyon Cho ◽  
Michael Luu
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Atherosclerotic Cardiovascular Disease ◽  
Practice Setting ◽  
Patients With Diabetes

Prevention of cardiovascular disease in type-2 diabetes: How to improve the clinical efficacy of aspirin

2005 ◽  
Vol 93 (01) ◽  
pp. 8-16 ◽  
Author(s):  
Licia Totani ◽  
Serenella Rotondo ◽  
Roberto Lorenzet ◽  
Gianni Tognoni ◽  
Giorgia De Berardis ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Clinical Efficacy ◽  
Diabetic Patients ◽  
Atherosclerotic Cardiovascular Disease ◽  
Low Dose Aspirin ◽  
Patients With Diabetes ◽  
Thrombotic Complications ◽  
Antithrombotic Efficacy

SummaryAtherosclerotic cardiovascular disease and its thrombotic complications are the principal causes of morbidity and mortality in patients with type-2 diabetes.Aspirin reduces the risk of thrombotic events in a broad range of patients with vascular disease and, in selected individuals, is beneficial for primary prevention. Although recommended by existing guidelines,in secondary and in primary prevention trials the clinical efficacy of low-dose aspirin in patients with diabetes appears to be substantially lower than in individuals without diabetes. In this review, we discuss possible mechanisms that may contribute to reduce the antithrombotic activity of aspirin in diabetes.We also discuss adjuvant therapies used in diabetic patients that may potentially improve the antithrombotic efficacy of aspirin.

Role of coronary artery calcium score in the primary prevention of cardiovascular disease

BMJ ◽  
2021 ◽  
pp. n776
Author(s):  
Khurram Nasir ◽  
Miguel Cainzos-Achirica
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Primary Prevention ◽  
Coronary Artery Calcium ◽  
Calcium Score ◽  
Coronary Plaque ◽  
Preventive Therapy ◽  
Atherosclerotic Cardiovascular Disease ◽  
International Studies

Abstract First developed in 1990, the Agatston coronary artery calcium (CAC) score is an international guideline-endorsed decision aid for further risk assessment and personalized management in the primary prevention of atherosclerotic cardiovascular disease. This review discusses key international studies that have informed this 30 year journey, from an initial coronary plaque screening paradigm to its current role informing personalized shared decision making. Special attention is paid to the prognostic value of a CAC score of zero (the so called “power of zero”), which, in a context of low estimated risk thresholds for the consideration of preventive therapy with statins in current guidelines, may be used to de-risk individuals and thereby inform the safe delay or avoidance of certain preventive therapies. We also evaluate current recommendations for CAC scoring in clinical practice guidelines around the world, and past and prevailing barriers for its use in routine patient care. Finally, we discuss emerging approaches in this field, with a focus on the potential role of CAC informing not only the personalized allocation of statins and aspirin in the general population, but also of other risk-reduction therapies in special populations, such as individuals with diabetes and people with severe hypercholesterolemia.

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.

scholarly journals Aspirin for Primary Prevention of Atherosclerotic Cardiovascular Disease: Challenges to Appropriate Use

2017 ◽  
Vol 4 (3) ◽  
pp. 159
Author(s):  
JoAnn Sperl-Hillen ◽  
Patrick O'Connor ◽  
Jay Desai ◽  
Karen Margolis ◽  
Heidi Ekstrom ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Atherosclerotic Cardiovascular Disease ◽  
Appropriate Use

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.

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