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Abstract Details

Aspirin as a Primary Prevention of Cardiovascular Disease in High-Risk New Diabetes Patients: A Retrospective Cohort Study in Taiwan
Cerebrovascular Disease and Interventional Neurology
S35 - Stroke Prevention Strategies (1:55 PM-2:06 PM)
006
Deciding whether to take aspirin as a primary prevention strategy for diabetic patients can be challenging, especially for those with high cardiovascular risk.
The aim of this study was to investigate the effects of aspirin in new diabetes patients who were at high cardiovascular risks.

We conducted a new user cohort between 2001 and 2012 for primary prevention of cardiovascular disease in diabetes patients aged over 20 years from the Taiwan Longitudinal Cohort of Diabetes Patients (LCDP). Based on 2018 Standards of Medical Care in Diabetes, we recruited high-risk patients. Diabetes patients at high risk of cardiovascular disease taking aspirin within one year of risk identification were assigned to the study group. We randomly selected four aspirin non-user as comparison cohort by propensity score matching. We used time-dependent Cox-regression to estimate the outcome for primary prevention, with aspirin allocation time as a time-varying variable.

We identified 12,129 aspirin uses and 48,516 non-users. The mean follow-up period for cardiovascular diseases was 2.67 years. The incidence of ischemic stroke events per 1,000 person-year in aspirin and comparison cohort was 2.40 and 4.76 respectively. The adjusted hazard ratio for ischemic stroke, ischemic heart disease and peripheral arterial disease in aspirin cohort was 0.59 (95% confidence interval [CI] 0.43-0.82), 0.87 (95% CI 0.68-1.11), and 0.56 (95% CI 0.36-0.87), respectively. The adjusted hazard ratio for major bleeding with aspirin treatment was 1.07 (95% CI 0.85-1.35).

Aspirin might provide benefits for diabetes patients who have no prior cardiovascular events but have a high cardiovascular risk. Future research on more detailed and precise risk stratification will help clinicians decide who should take aspirin.

Authors/Disclosures
Chiawei Chiang, MD (Changhua Christian Hospital)
PRESENTER
No disclosure on file
No disclosure on file
No disclosure on file
Yen-Yu Chen, MD (Changhua Christian Hospital) No disclosure on file