Mortality and glycemic control among patients with gastric and esophageal cancer and diabetes mellitus.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 73-73
Author(s):  
Nina J. Karlin ◽  
Matthew Buras ◽  
Heidi E. Kosiorek ◽  
Patricia M. Verona ◽  
Curtiss B. Cook
Keyword(s):  
Diabetes Mellitus ◽  
Esophageal Cancer ◽  
Glycemic Control ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Cox Regression ◽  
Hazard Ratio ◽  
Matched Pairs ◽  
Cox Regression Analysis ◽  
The Impact

73 Background: This study evaluated the impact of diabetes mellitus (DM) on survival in gastric and esophageal cancer patients, and examined the impact of these cancers on glycemic control in DM. Methods: Patients with newly diagnosed gastric and esophageal cancers with DM (n = 92) were identified from the Institutional Cancer Registry and matched to 92 gastric and esophageal cancer patients without DM according to age, gender and year of cancer diagnosis (2006 to 2016). The electronic medical record provided information on DM and cancer therapies and laboratory results. Overall survival (OS) was estimated with the Kaplan-Meier method and compared by Cox regression analysis using stratification for matched pairs. Mixed models were used to compare hemoglobin A1c (HbA1c) and glucose during the year following cancer diagnosis. Results: Mean age of the entire cohort was 68 years, 91% were white, 78% were men, and 53% had stage III/IV disease. Adenocarcinoma (79%) was the most common histologic type. BMI was significantly different between DM and non-DM patients (p = 0.006). Alcohol use at time of cancer diagnosis was more prevalent in non-DM patients vs. DM (p = 0.018). Among those with DM, mean HbA1c during the year following cancer diagnosis was 6.8%. Mean glucose was significantly different between DM and non-DM patients (149 mg/dL vs. 116 mg/dL, p < 0.001). For glucose, there was a significant interaction effect (p = 0.005) as DM patients demonstrated a decrease in glucose values over time compared to non-DM patients. Median follow-up time was 35 months. Three year OS was estimated at 46% (95% CI: 36-58%) for DM patients versus 52.0% (95% CI: 41-64%) in non-DM (p = 0.25). Hazard ratio (stratification for matched pairs) was 1.95 (95% CI: 1.14 – 3.43; p = 0.02). Three year PFS was estimated at 40% (95% CI: 31-53%) for DM patients versus 50% (95% CI: 40-63%) for non-DM patients (p = 0.12). Hazard ratio (stratification for matched pairs) was 1.74 (95% CI: 1.04-2.90; p = 0.03). Conclusions: Gastric and esophageal cancer and its treatment did not affect glycemic control. Risks of death and progression are greater in DM patients as compared to non-DM.

Implications of neuroendocrine tumor and diabetes mellitus on patient outcomes and care: A matched case control study.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 612-612
Author(s):  
Nina J. Karlin ◽  
Heidi E. Kosiorek ◽  
Matthew Buras ◽  
Kelley Rone ◽  
Patricia M. Verona ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Neuroendocrine Tumor ◽  
Cancer Diagnosis ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Rank Test ◽  
Matched Pairs ◽  
Kaplan Meier ◽  
The Impact

612 Background: The aim of this study was to examine the impact of diabetes mellitus (DM) on survival in neuroendocrine tumor and the impact of neuroendocrine tumor on glycemic control in DM. Methods: Patients with newly diagnosed neuroendocrine tumor with and without DM were matched 1:1 according to age, gender, and year of cancer diagnosis (2005-2017). The file was linked to the electronic medical record to obtain information on DM and neuroendocrine tumor therapies and laboratory results. There were 59 matched pairs (total 118 patients) included in the analysis. We compared characteristics between cases and controls and assessed survival with the Kaplan-Meier method and Cox proportional hazards model. Mixed models compared hemoglobin A1c and glucose levels over time. Results: Median age of patients at diagnosis was 67 (40-86); 41% had stage IV disease. Women constituted 49% of the study population; 22% had pancreatic neuroendocrine tumor and 45% had another GI primary neuroendocrine tumor. No differences in race/ethnicity, marital status, alcohol or tobacco use were detected between cancer patients with and without DM. Mean BMI was significantly different between DM and non-DM patients (31.0 [7.90] versus 26.4 [5.27]); p = 0.011. Among those with DM, mean HbA1c during the year following cancer diagnosis was 7.3%. Mean glucose was significantly different between DM (159.1 [43.5] versus non-DM pts 117 [31.5]); p < 0.001. Median follow-up time was 32.8 (2.4-165.4) months in alive patients. Three year survival was estimated at 72% (95% CI: 60-86%) for DM patients versus 80% (95% CI: 70-92%) in non-DM patients by Kaplan Meier method (p = 0.82 log rank test). Hazard ratio (stratification for matched pairs) = 1.33 (95% CI: 0.56 – 3.16; p = 0.51). Conclusions: DM did not adversely impact survival in patients with neuroendocrine tumor. Neuroendocrine tumor and its treatment did not affect glycemic control. This should be reassuring to oncologists and endocrinologists who treat patients with neuroendocrine tumors and diabetes.

scholarly journals MON-131 Mortality and Glycemic Control Among Patients with Leukemia and Diabetes Mellitus: A Case-Control Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Erin Wiedmeier ◽  
Luke Mountjoy ◽  
Patricia Verona ◽  
Heidi Kosiorek ◽  
Matthew Buras ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Hazard Ratio ◽  
Cox Proportional Hazards Model ◽  
Solid Organ ◽  
Matched Pairs ◽  
Total N ◽  
Kaplan Meier ◽  
The Impact ◽  
Over Time

Abstract Background: Unlike with solid organ cancers, little data is available on how diabetes mellitus (DM) and hematologic malignancies interact to affect survival and glycemic control. We examined the impact of DM on survival in patients with leukemia and the effect of leukemia on glycemic control. Materials and Methods: Patients with leukemia with and without DM were matched 1:1 (2007–2017), 70 matched pairs (total N=140 pts) were included in the analysis. We compared characteristics between cases and controls and assessed survival with the Kaplan-Meier method and Cox proportional hazards model. Mixed models compared hemoglobin A1c (HbA1c) and glucose levels over time. Results: The median age of patients at diagnosis was 56 (18–94); 60% were male and 89% had acute leukemia. Among those with DM, HbA1c was only recorded in 25 of 70 patients during the year following cancer diagnosis and was 6.8%. There was no change in HbA1c values over time in these DM patients. Mean glucose was significantly different between DM and non-DM patients (p&lt;0.001). Time (days since leukemia diagnosis) was significant (p&lt;0.001) and there was a significant interaction effect (p=0.01). Glucose values increased in the DM patients during the year following diagnosis, while remaining stable in those without DM. Median follow-up time was 23.2 months. Three-year survival was estimated at 46% for DM patients versus 45% in non-DM pts by Kaplan Meier method (p=0.79). Hazard ratio (stratification for matched pairs) was 1.05 (95% CI: 0.57 - 1.94; p=0.88). Three-year relapse-free survival was estimated at 34% for DM patients versus 43% for non-DM patients (p=0.58). Hazard ratio (stratification for matched pairs) = 1.10 (95% CI: 0.61–1.98; p=0.76). Conclusions: DM did not adversely impact survival in patients with leukemia. Leukemia and its treatment did not affect glycemic control. This should be reassuring to hematologists and endocrinologists who treat patients with leukemia and diabetes.

Identification and Characterization of Recurrent Venous Thrombosis In Cancer Patients

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3328-3328
Author(s):  
Catherine Weber ◽  
Nelly G. Adel ◽  
Elyn Riedel ◽  
Gerald A. Soff
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Hazard Ratio ◽  
Older Age ◽  
Recurrent Thrombosis ◽  
Recurrent Vte ◽  
The Impact

Abstract Abstract 3328 Background: Venous thromboembolism (VTE) is a common cause of morbidity and mortality in cancer patients. Standard of care for treatment is Low Molecular Weight Heparin, but recurrence of VTE remains a concern. We performed a retrospective analysis of our institutional experience, to characterize the patients who had a recurrence of VTE while on therapeutic doses of Dalteparin. Objectives: 1. To determine the VTE recurrence rate for cancer patients on therapeutic Dalteparin. 2. To elucidate potential risk factors for recurrence. 3. To determine the impact of recurrent VTE on overall survival. Methods: Patients beginning treatment for VTE with dalteparin between 1/1/2008 and 12/10/ 2009 were retrospectively identified through the hospital's electronic medical records system and cases of recurrent VTE were characterized. Overall survival was estimated using the Kaplan-Meier method and the influence of VTE recurrence on overall survival was analyzed as a time-dependent covariate using a Cox proportional hazards model. Results: 1,392 patients, treated for VTE with dalteparin were included in this study. 34 recurrent VTE episodes were identified. The overall incidence of recurrent thrombosis by six months was 2.3% (95% CI: 1.7%-3.3%). Older age was significantly associated with recurrence (p=0.04). Lung cancer patients had a significantly elevated risk of recurrence (5.6%, p=0.03). No other cancer types were associated with a significant trend to increased recurrent VTE rates. The incidence of recurrent VTE was higher among females compared to males (3.0% vs. 1.6%), although this trend was not statistically significant (P = 0.08). After adjusting for gender, sex and cancer diagnosis, developing a recurrent VTE was associated with a 3.0-fold hazard ratio of death (<0.0001). Conclusions: The rate of recurrent VTE in cancer patients at MSKCC is low in comparison with previously published reports. However, we identified both older age and lung cancer diagnosis as statistically significant risk factors for recurrent VTE. Females also experienced a higher rate of recurrent thrombosis when compared to males, although this result was not statistically significant. The hazard ratio for death was three times that for a patient with recurrent thrombosis when compared to one without subsequent VTE, suggesting recurrence of VTE remains an important influence on cancer-associated mortality. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Cohort Study of the Impact of Time to Antibiotic Administration on Mortality in Patients with Febrile Neutropenia

2014 ◽  
Vol 58 (7) ◽  
pp. 3799-3803 ◽  
Author(s):  
Regis G. Rosa ◽  
Luciano Z. Goldani
Keyword(s):  
Cohort Study ◽  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Cox Regression ◽  
Mortality Rates ◽  
Cox Proportional Hazards Model ◽  
Rank Test ◽  
Antibiotic Administration ◽  
Cox Regression Analysis ◽  
The Impact

ABSTRACTThe time to antibiotic administration (TTA) has been proposed as a quality-of-care measure in febrile neutropenia (FN); however, few data regarding the impact of the TTA on the mortality of adult cancer patients with FN are available. The objective of this study was to determine whether the TTA is a predictor of mortality in adult cancer patients with FN. A prospective cohort study of all consecutive cases of FN, evaluated from October 2009 to August 2011, at a single tertiary referral hospital in southern Brazil was performed. The TTA was assessed as a predictive factor for mortality within 28 days of FN onset using the Cox proportional hazards model. Kaplan-Meier curves were used for an assessment of the mortality rates according to different TTAs; the log-rank test was used for between-group comparisons. In total, 307 cases of FN (169 subjects) were evaluated. During the study period, there were 29 deaths. In a Cox regression analysis, the TTA was independently associated with mortality within 28 days (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.10 to 1.26); each increase of 1 h in the TTA raised the risk of mortality within 28 days by 18%. Patients with FN episodes with a TTA of ≤30 min had lower 28-day mortality rates than those with a TTA of between 31 min and 60 min (3.0% versus 18.1%; log-rankP= 0.0002). Early antibiotic administration was associated with higher survival rates in the context of FN. Efforts should be made to ensure that FN patients receive effective antibiotic therapy as soon as possible. A target of 30 min to the TTA should be adopted for cancer patients with FN.

Diabetes mellitus and survival of esophageal cancer patients after esophagectomy: a systematic review and meta-analysis

2020 ◽  
Vol 33 (2) ◽  
Author(s):  
Xi Zheng ◽  
Xingsheng Ma ◽  
Han-Yu Deng ◽  
Panpan Zha ◽  
Jie Zhou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Esophageal Cancer ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Outcome Data ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference ◽  
The Impact

SUMMARY Diabetes mellitus (DM) is one of the most common comorbidities in esophageal cancer patients who undergo esophagectomy. It is well established that DM has an unfavorable impact on short-term outcomes of patients with surgically treated esophageal cancer; however, whether DM has any impact on long-term survival of these patients remains unclear. We performed the first meta-analysis to investigate the impact of DM on survival of surgically treated esophageal cancer patients. We searched the following databases systematically to retrieve relevant studies on January 2, 2019: PubMed, Embase, and Web of Science. The main outcome data consisting of 3- and 5-year overall survival (OS) rates and hazard ratios (HRs) of OS were extracted to compare survival between patients with and without DM. We finally included for meta-analysis a total of eight cohort studies involving 5,044 esophageal cancer patients who underwent esophagectomy. We found no significant difference between 3-year (risk ratio [RR] = 0.94, 95% CI: 0.73–1.21; P = 0.65) and 5-year (RR = 0.92, 95% CI: 0.80–1.08; P = 0.31) OS rates between patients with and without DM after esophagectomy. Moreover, DM was not found to be an independent predictor of OS for these patients (HR = 1.10, 95% CI: 0.65–1.84; P = 0.72). Our study suggests that DM appears to have no significant impact on long-term survival of esophageal cancer patients who undergo esophagectomy. To improve the prognosis of these patients, it may be more important to control glycemic level in patients with DM who undergo esophagectomy. However, further high-quality studies with appropriate adjustment for confounding factors are needed to verify this conclusion.

Adjuvant treatment for resected rectal cancer: Effect of postoperative oxaliplatin added to 5-FU in the neoadjuvant era.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 672-672
Author(s):  
Benjamin Garlipp ◽  
Patrick Stuebs ◽  
Hans Lippert ◽  
Karsten Ridwelski ◽  
Henry Ptok ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Colon Cancer ◽  
Regression Analysis ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Data Set ◽  
Cox Regression Analysis ◽  
The Impact

672 Background: Oxaliplatin (Ox) added to postoperative 5-fluorouracil (5FU) based adjuvant treatment has shown a survival benefit in colon cancer. For rectal cancer, the impact of Ox on survival has almost exclusively been tested in studies using 5FU +/- Ox both as a component of preoperative chemoradiotherapy (CRT) and as adjuvant treatment. Only one study (NCT00807911) investigated adjuvant 5FU +/- Ox in patients undergoing preop 5FU based CRT without Ox. Thus, the evidence for the benefit of adding Ox to adjuvant 5FU in patients treated with preop 5FU based CRT is limited. Methods: Data from the prospective German multicenter Quality Assurance in Rectal Cancer observational trial involving more than 300 hospitals of all levels of care throughout Germany were retrospectively analyzed. Patients undergoing R0 total mesorectal excision (TME) for rectal cancer following neoadjuvant 5FU based treatment without oxaliplatin between 01/01/2008 and 12/31/2010 were included. Disease-free survival (DFS) in patients receiving adjuvant treatment with or without Ox was compared using the Kaplan Meier method. The impact of adjuvant treatment with 5FU with or without Ox on DFS was investigated in a Cox regression analysis including open vs. laparoscopic approach, pT stage, pN stage, tumor grading, TME quality grade, and presence of anastomotic leakage as potential confounding factors. Results: The entire data set included 1,861 patients. Data for all variables investigated were available for 599 patients of whom 512 (85%) and 89 (15%) received 5FU based adjuvant treatment without and with Ox, respectively. Mean DFS was not different in patients receiving 5FU only vs. 5FU with Ox (p=0.103). Cox regression analysis revealed no significant impact of adding Ox to adjuvant 5FU on DFS. Of all factors analyzed, only pN2 (vs. pN0) status had an independent adverse effect on DFS (Hazard ratio 4.22, p<0.001). Conclusions: These data indicate that adjuvant Ox added to 5FU does not provide a DFS benefit in rectal cancer patients treated with preoperative 5FU based CRT under routine care conditions. Rectal cancer patients may be different from patients with colon cancer with respect to benefit from adjuvant Ox.

Breast Cancer in Mosul: A Survival Analysis

2020 ◽  
pp. 31-36
Keyword(s):  
Breast Cancer ◽  
Survival Analysis ◽  
Cancer Patients ◽  
Cox Regression ◽  
Hazard Ratio ◽  
Breast Cancer Patients ◽  
Cox Regression Analysis ◽  
Radical Removal ◽  
One Year ◽  
The Right

Breast cancer is the most common cancer in women, and the major cause of death. This study was conducted in order to make a descriptive study and survival analysis for breast cancer patients in Mosul. Two hundred forty-six early diagnosed women with breast cancer out of 290 patients were included during the period from March 2007 to February 2012. The average follows up was 36. months (range: 11-67 months). The patients were undergone modified radical removal of the breast, chemotherapy and deep radiation. Patients with estrogen positive were given tamoxifen for five years. Patients with Her2/neu positive were given trastuzumab with docytaxil for one year. Only 25 patients (10.2%) died during the study. The highest incidence of breast cancer (35.8%) was between the ages 51 ≥ 60 years. The presentation of cancer was high (90.1%) in the lumber. Tumor in the right side (66.35%) was significantly higher than the left side. Metastasis was high (25%) and most of them in the liver (19.1%). The percentage of patients with positive estrogen, progesterone, and Her2/neu receptors were not different from negative receptors. Cox regression analysis showed that metastasis had significant effect on death (hazard ratio=2.917). Age 31 ≥ 40 years was the least affected age (hazard ratio=0.034). In conclusion, survival rate of breast cancer patients in Mosul is high due to good management. The early detection of cancer is the best way for survival of the patients, by developing the educational programs.

scholarly journals Chronic Diseases among Older Cancer Survivors

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Laura Deckx ◽  
Marjan van den Akker ◽  
Job Metsemakers ◽  
André Knottnerus ◽  
François Schellevis ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Venous Thrombosis ◽  
Cancer Patients ◽  
Chronic Diseases ◽  
Cancer Diagnosis ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Older Cancer Patients ◽  
After Cancer ◽  
Colorectal Cancer Patients

Objective. To compare the occurrence of pre-existing and subsequent comorbidity among older cancer patients (≥60years) with older non-cancer patients.Material and Methods. Each cancer patient (n=3835, mean age 72) was matched with four non-cancer patients in terms of age, sex, and practice. The occurrence of chronic diseases was assessed cross-sectionally (lifetime prevalence at time of diagnosis) and longitudinally (incidence after diagnosis) for all cancer patients and for breast, prostate, and colorectal cancer patients separately. Cancer and non-cancer patients were compared using logistic and Cox regression analysis.Results. The occurrence of the most common pre-existing and incident chronic diseases was largely similar in cancer and non-cancer patients, except for pre-existing COPD (OR 1.21, 95% CI 1.06–1.37) and subsequent venous thrombosis in the first two years after cancer diagnosis (HR 4.20, 95% CI 2.74–6.44), which were significantly more frequent (P<0.01) among older cancer compared to non-cancer patients.Conclusion. The frequency of multimorbidity in older cancer patients is high. However, apart from COPD and venous thrombosis, the incidence of chronic diseases in older cancer patients is similar compared to non-cancer patients of the same age, sex, and practice.

Passive Smoking Increases the Risk for Intestinal Surgeries in Patients With Crohn’s Disease

2020 ◽  
Author(s):  
Susanna Scharrer ◽  
Donata Lissner ◽  
Christian Primas ◽  
Walter Reinisch ◽  
Gottfried Novacek ◽  
...  
Keyword(s):  
Risk Factor ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Passive Smoking ◽  
Cox Regression ◽  
Hazard Ratio ◽  
Active Smoking ◽  
Intestinal Surgery ◽  
Cox Regression Analysis ◽  
The Impact

Abstract Background Despite substantial evidence on the negative effect of active smoking, the impact of passive smoking on the course of Crohn’s disease (CD) remains largely unclear. Our aim was to assess passive smoking as a risk factor for intestinal surgeries in CD. Methods The study was conducted in a university-based, monocentric cohort of 563 patients with CD. Patients underwent a structured interview on exposure to passive and active smoking. For clinical data, chart review was performed. Response rate was 84%, leaving 471 cases available for analysis. For evaluation of the primary objective, which was the impact of exposure to passive smoking on the risk for intestinal surgery, only never actively smoking patients were included. Results Of 169 patients who never smoked actively, 91 patients (54%) were exposed to passive smoking. Exposed patients were more likely to undergo intestinal surgery than nonexposed patients (67% vs 30%; P &lt; 0.001). Multivariate Cox regression analysis revealed that passive smoking was an independent risk factor for intestinal surgeries (hazard ratio, 1.7; 95% CI, 1.04–2.9; P = 0.034) after adjustment for ileal disease at diagnosis (hazard ratio, 2.9; 95% CI, 1.9–4.5; P &lt; 0.001) and stricturing or penetrating behavior at diagnosis (hazard ratio, 1.9; 95% CI, 1.2–3.1; P = 0.01). Passive smoking during childhood was a risk factor for becoming an active smoker in later life (odds ratio, 2.2; 95% CI, 1.5–3.2; P &lt; 0.001). Conclusion Passive smoking increases the risk for intestinal surgeries in patients with CD.

scholarly journals Impaired Clinical Efficacy of Aspirin in Hypoalbuminemic Patients With Diabetes Mellitus

2021 ◽  
Vol 12 ◽  
Author(s):  
Angela Sciacqua ◽  
Francesco Andreozzi ◽  
Elena Succurro ◽  
Daniele Pastori ◽  
Vittoria Cammisotto ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Serum Albumin ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Cox Regression ◽  
Coronary Revascularization ◽  
Cox Regression Analysis ◽  
Fasting Plasma ◽  
Increased Risk ◽  
The Impact

Objective: To investigate the impact of albumin levels on the aspirin efficacy, since aspirin inhibits platelet aggregation (PA) by cyclooxygenase one irreversible acetylation that is less effective in patients with type 2 diabetes mellitus (T2DM).Patients and Methods: A total of 612 aspirin (100 mg/day)-treated T2DM patients were followed-up for 54.4 ± 7.3 months. The primary endpoint, a composite of cardiovascular events (CVEs) including CV death, myocardial infarction, ischemic stroke and coronary revascularization, was analysed according to baseline values of serum albumin (≥ or &lt; 3.5 g/dL). Serum thromboxane (Tx)B2 was also measured.Results: 250 (40.8%) patients had serum albumin &lt; 3.5 g/dL; these patients were overweight and had higher values of fibrinogen (p = 0.009), high sensitivity C-reactive protein (p = 0.001) and fasting plasma glucose (p &lt; 0.0001) compared to those with albumin ≥ 3.5 g/dL. During follow-up, 86 CVEs were recorded, 49 and 37 in patients with serum albumin &lt; or ≥3.5 g/dL, respectively (p = 0.001). At multivariable Cox regression analysis, serum albumin &lt; 3.5 g/dL (hazard ratio [HR] 1.887, 95% confidence interval [CI] 1.136–3.135, p = 0.014), age (HR 1.552 for every 10 years, 95%CI 1.157–2.081, p = 0.003), fasting plasma glucose (HR 1.063, 95%CI 1.022–1.105, p = 0.002) and beta-blocker use (HR 0.440, 95%CI 0.270–0.717, p = 0.001) were associated to CVEs. Serum TxB2 levels (n = 377) were 0.32 ± 0.12 and 0.24 ± 0.12 ng/ml in patients with albumin &lt; or ≥ 3.5 g/dL, respectively (p &lt; 0.001).Conclusion: In T2DM patients, the efficacy of aspirin varies according to albumin levels. Hypoalbuminemia associated with impaired TxB2 inhibition and an increased risk of long-term CVEs.

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