TITLE

Differential Effect of Low-Dose Aspirin for Primary Prevention of Atherosclerotic Events in Diabetes Management

AUTHOR(S)
OKADA, SADANORI; MORIMOTO, TAKESHI; OGAWA, HISAO; KANAUCHI, MASAO; NAKAYAMA, MASAFUMI; UEMURA, SHIRO; DOI, NAOFUMI; JINNOUCHI, HIDEAKI; WAKI, MASAKO; SOEJIMA, HIROFUMI; SAKUMA, MIO; SAITO, YOSHIHIKO
PUB. DATE
June 2011
SOURCE
Diabetes Care;Jun2011, Vol. 34 Issue 6, p1277
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVE--Recent reports showed that low-dose aspirin was ineffective in the primary prevention of cardiovascular events in diabetic patients overall. We hypothesized that low-dose aspirin would be beneficial in patients receiving insulin therapy, as a high-risk group. RESEARCH DESIGN AND METHODS--This study is a subanalysis of the Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) trial--a randomized, controlled, open-label trial. We randomly assigned 2,539 patients with type 2 diabetes and no previous cardiovascular disease to the low-dose aspirin group (81 or 100 mg daily) or to the no-aspirin group. The median follow-up period was 4.4 years. We investigated the effect of low-dose aspirin on preventing atherosclerotic events in groups receiving different diabetes management. RESULTS--At baseline, 326 patients were treated with insulin, 1,750 with oral hypoglycemic agents (OHAs), and 463 with diet alone. The insulin group had the longest history of diabetes, the worst glycemic control, and the highest prevalence of diabetic microangiopathies. The dietalone group had the opposite characteristics. The incidence of atherosclerotic events was 26.6, 14.6, and 10.4 cases per 1,000 person-years in the insulin, OHA, and diet-alone groups, respectively. In the insulin and OHA groups, low-dose aspirin did not affect atherosclerotic events (insulin: hazard ratio [HR] 1.19 [95% Cl 0.60-2.40]; OHA: HR 0.84 [0.57-1.24]). In the dietalone group, low-dose aspirin significantly reduced atherosclerotic events, despite tire lowest event rates (HR 0.21 [0.05-0.64]). CONCLUSIONS--Low-dose aspirin reduced atherosclerotic events predominantly in the diet-alone group and not in the insulin or OHA groups.
ACCESSION #
65098988

 

Related Articles

  • Type 2 Diabetes As An Inflammatory Cardiovascular Disorder. Ziegler, D. // Current Molecular Medicine;May2005, Vol. 5 Issue 3, p309 

    Type 2 diabetes carries a 2-6-fold increased risk of cardiovascular disease (CVD) and death. Indeed, the risk of major cardiovascular events in Type 2 diabetic patients without history of coronary heart disease (CHD) is equivalent to that observed in non-diabetic subjects with CHD. However,...

  • The Emerging Health Benefits of Coffee with an Emphasis on Type 2 Diabetes and Cardiovascular Disease. Bidel, Siamak; Tuomilehto, Jaakko // European Endocrinology;Autumn2013, Vol. 9 Issue 2, p99 

    Debate persists whether coffee is beneficial or problematic for human health, coffee consumption has been associated with a decrease in risk of developing type 2 diabetes, and numerous epidemiological studies have demonstrated that healthy, habitual coffee drinkers are more protected from the...

  • Insulin resistance syndrome and cardiovascular risk.  // CMAJ: Canadian Medical Association Journal;5/10/2005, Vol. 172 Issue 10, p1267 

    Presents a summary of article dealing with insulin resistance syndrome and cardiovascular risk.

  • Insulin resistance in men with treated hypertension at increased risk for cardiovascular disease: Results of a 3-year study Mohteshamzadeh, Mobin; Wilkinson, Robert; Thomas, Simon H.L. // American Journal of Hypertension;Apr2005, Vol. 18 Issue 4, p452 

    Background: Insulin resistance is an independent risk factor for cardiovascular disease. The aim of this research was to establish the frequency of insulin resistance in a normoglycemic, hypertensive, male population to determine whether insulin resistance could be predicted by assessment of...

  • Vectocardiographic "Bites" as Possible Early Findings of Cardiac Involvement in Diabetic Patients Without Clinical Evidence of Heart Disease. Giampietro, Ottavio; Santoro, Gino; Rossi, Marco; Luche, Alessandro Dalle; Giusti, Costantino; Navalesi, Renzo // Angiology;Oct1982, Vol. 33 Issue 10, p668 

    We performed a standard vectocardiogram (VCG) in 87 diabetics, aged 20-77 years, orally- or insulin-treated, and in 41 normal subjects. None had cardiac history or symptoms. Among diabetics, 31 had no vectocardiographic abnormalities, 23 had various VCG changes, 33 showed electrical "bites'' of...

  • Comprehensive genetic analysis of the dipeptidyl peptidase-4 gene and cardiovascular disease risk factors in obese individuals. Bouchard, Luigi; Faucher, Geneviève; Tchernof, André; Deshaies, Yves; Lebel, Stéfane; Hould, Frédéric-Simon; Marceau, Picard; Vohl, Marie-Claude // Acta Diabetologica;Mar2009, Vol. 46 Issue 1, p13 

    The incretin system has been shown to stimulate insulin secretion in a glucose dependent manner and currently fosters considerable hope for the treatment of diabetes. Recently, we have shown that the dipeptidylpeptidase-4 ( DPP4) gene, which is responsible for incretin inactivation, was...

  • JPAD: Low-dose aspirin did not reduce risk of CV events in Japanese patients with type 2 diabetes.  // Endocrine Today;12/10/2008, Vol. 6 Issue 22, p8 

    This article discusses the results of the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes study. Researchers enrolled patients with type 2 diabetes and with no history of atherosclerotic disease. They found that low-dose aspirin did not reduce the risk for cardiovascular...

  • Subclinical Atherosclerosis and Metabolic Risk: Role of Body Mass Index and Waist Circumference. Camhi, Sarah M.; Katzmarzyk, Peter T.; Broyles, Stephanie T.; Srinivasan, Sathanur R.; Chen, Wei; Bouchard, Claude; Berenson, Gerald S. // Metabolic Syndrome & Related Disorders;Apr2011, Vol. 9 Issue 2, p119 

    Background: Carotid artery intima-media thickness (IMT) is greater in adults with elevated metabolic risk profiles. However, the influence of body mass index (BMI) or waist circumference (WC) on the relationship between IMT and metabolic risk is unclear. Methods: Adults from the Bogalusa Heart...

  • Type 2 Diabetes: An Atherothrombotic Syndrome. Dunn, E. J.; Grant, P. J. // Current Molecular Medicine;May2005, Vol. 5 Issue 3, p323 

    Insulin resistance is found in around 80-90% of subjects with older onset (type 2) diabetes and in approximately 25% of the general population. Insulin resistance prior to the development of frank type 2 diabetes and type 2 diabetes itself is associated with a significant increase in the risk of...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics