Lack of effect of aspirin in primary CV prevention in type 2 diabetic patients with nephropathy: results from 8 years follow-up of NID-2 study

Ferdinando Carlo Sasso*, Raffaele Marfella, Antonio Pagano, Giovanni Porta, Giuseppe Signoriello, Nadia Lascar, Roberto Minutolo, Ornella Carbonara, Marcello Persico, Federico Piscione, Luca de Nicola, Roberto Torella, Giuseppe Paolisso

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

The risk-to-benefit ratio for the use of low dose of aspirin in primary cardiovascular (CV) prevention in patients with diabetes mellitus remains to be clarified. We assessed the effect of aspirin on risk of CV events in type 2 diabetic patients with nephropathy, in order to verify the usefulness of Guidelines in clinical practice. We carried out a prospective multicentric study in 564 patients with type 2 diabetic nephropathy free of CV disease attending outpatient diabetes clinics. A total of 242 patients received antiplatelet treatment with aspirin 100 mg/day (group A), and 322 were not treated with antiplatelet drugs (group B). Primary end point was the occurrence of total major adverse cardio-vascular events (MACE). Secondary end points were the relative occurrence of fatal MACE. The average follow-up was 8 years. Total MACE occurred in 49 patients from group A and in 52 patients from group B. Fatal MACE occurred in 22 patients from group A and in 20 from group B; nonfatal MACE occurred in 27 patients from group A and in 32 patients from group B. Kaplan-Meier analysis did not show a statistically significant difference of cumulative MACE between the two groups. A not statistically significant difference in the incidence of both fatal (p = 0.225) and nonfatal CV events (p = 0.573) between the two groups was observed. These results were confirmed after adjustment for confounders (HR for MACE 1.11, 95 % CI 0.91-1.35). These findings suggest that low dose of aspirin is ineffective in primary prevention for patients with nephropathy.

Original languageEnglish
Pages (from-to)239-247
Number of pages9
JournalActa Diabetologica
Volume52
Issue number2
Early online date11 Aug 2014
DOIs
Publication statusPublished - 1 Apr 2015

Bibliographical note

Funding: Italian Government grant from M.I.U.R. (Ministero della Istruzione, Università e Ricerca).

Keywords

  • aspirin
  • CV prevention
  • nephropathy

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