 |
|
Aspirin does not prevent heart attacks in patients with diabetes
October 17, 2008The prevention of progression of arterial disease and diabetes: a factorial randomized placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease
Taking regular aspirin and antioxidant supplements does not prevent heart attacks even in high risk groups with diabetes and asymptomatic arterial disease, and aspirin should only be given to patients with established heart disease, stroke or limb arterial disease, according to a study published today on bmj.com.
In light of these findings, and the evidence from six other well controlled trials, the prescribing practice of doctors and international guidelines should be reviewed so that aspirin is only prescribed to patients with established heart and stroke disease, argues the author of an accompanying editorial.
Patients with diabetes are two to five times more likely to suffer from heart disease than the general population and heart disease is a major cause of death in patients with type 1 and 2 diabetes. Although there is considerable evidence showing no protective benefit of aspirin in high risk patients without heart disease, guidelines are inconsistent and aspirin is commonly prescribed for the primary prevention of heart disease in patients with diabetes and with peripheral arterial disease.
But aspirin is one of the top 10 causes of adverse drug events reported to the Commission on Human Medicines. It causes gastrointestinal bleeding and the risk of bleeding increases with age and prolonged use.
Professor Jill Belch and colleagues from Scotland investigated whether aspirin and antioxidants given together or separately can reduce heart attacks and death in patients with diabetes and arterial disease. 1276 patients with diabetes and evidence of artery disease over 40 years of age were randomised to receive either aspirin or placebo, an antioxidant or placebo, aspirin and antioxidant or double placebo, and followed over eight years.
Overall, the researchers found no benefit from either aspirin or antioxidant treatment in the prevention of heart attacks or death. Patients in the aspirin groups had 116 primary events compared with 117 in the placebo group. No significant difference in events was seen between the antioxidant group and the placebo group.
The authors conclude by voicing their concern at the widespread prescribing of aspirin despite the lack of evidence to support its use in the primary prevention of heart attacks and death in people with diabetes and in view of its possible side effects.
These findings show that unlike statins and drugs for reducing hypertension, which have a benefit in all risk groups including those with and without heart disease, only patients with a history of clinical or symptomatic heart disease or stroke disease benefit from taking aspirin, writes Professor William Hiatt in an accompanying editorial.
BMJ-British Medical Journal
Patients with diabetes are two to five times more likely to suffer from heart disease than the general population and heart disease is a major cause of death in patients with type 1 and 2 diabetes. Although there is considerable evidence showing no protective benefit of aspirin in high risk patients without heart disease, guidelines are inconsistent and aspirin is commonly prescribed for the primary prevention of heart disease in patients with diabetes and with peripheral arterial disease.
But aspirin is one of the top 10 causes of adverse drug events reported to the Commission on Human Medicines. It causes gastrointestinal bleeding and the risk of bleeding increases with age and prolonged use.
Professor Jill Belch and colleagues from Scotland investigated whether aspirin and antioxidants given together or separately can reduce heart attacks and death in patients with diabetes and arterial disease. 1276 patients with diabetes and evidence of artery disease over 40 years of age were randomised to receive either aspirin or placebo, an antioxidant or placebo, aspirin and antioxidant or double placebo, and followed over eight years.
Overall, the researchers found no benefit from either aspirin or antioxidant treatment in the prevention of heart attacks or death. Patients in the aspirin groups had 116 primary events compared with 117 in the placebo group. No significant difference in events was seen between the antioxidant group and the placebo group.
The authors conclude by voicing their concern at the widespread prescribing of aspirin despite the lack of evidence to support its use in the primary prevention of heart attacks and death in people with diabetes and in view of its possible side effects.
These findings show that unlike statins and drugs for reducing hypertension, which have a benefit in all risk groups including those with and without heart disease, only patients with a history of clinical or symptomatic heart disease or stroke disease benefit from taking aspirin, writes Professor William Hiatt in an accompanying editorial.
BMJ-British Medical Journal
Arterial Disease Current Events and Arterial Disease News RSSExposure to several common infections over time may be associated with risk of stroke
Cumulative exposure to five common infection-causing pathogens may be associated with an increased risk of stroke, according to a report posted online today that will appear in the January 2010 print issue of Archives of Neurology, one of the JAMA/Archives journals.
Lifestyle changes remain important in fighting peripheral arterial disease
Modifying the risk of peripheral arterial disease (or PAD)-with healthy lifestyle changes-remains vital to one's health, note researchers in a recent issue of the Journal of Vascular and Interventional Radiology.
Aspirin works for primary prevention in moderate and high risk diabetics
The beneficial effects of aspirin in primary prevention of cardiovascular events i.e. stroke, MI and cardiac death are known and generally accepted.
Psoriasis associated with cardiovascular disease and increased mortality
The skin disease psoriasis is associated with atherosclerosis (a buildup of plaque in the arteries) characterized by an increased prevalence of ischemic heart disease, cerebrovascular disease, peripheral artery disease and an increased risk of death.
Promising 3-year data: Saving limbs with drug-eluting stents
Attempts to treat critical limb ischemia in peripheral arterial disease (PAD) patients with below-the-knee angioplasty are still thwarted by restenosis (the re-narrowing of the artery at the site of angioplasty or stenting), the need for repeat treatments and the continued progression of atherosclerotic disease, leading to tissue death (gangrene) and amputation.
'Seeing' stem cells helps in fight against peripheral arterial disease
Interventional radiologists are fitting together the puzzle pieces of how to use stem cells to create new or more blood vessels to treat peripheral arterial disease (PAD) in those individuals with extensively narrowed or clogged arteries.
Simple test helps predict heart attack risk
The use of common and readily available screening tests-like the ankle brachial index (ABI)-along with traditional risk scoring systems-such as the Framingham Risk Score-has the potential to prevent devastating heart attacks in thousands of individuals who are not originally thought to be at high risk (according to Framingham alone), say researchers at the Society of Interventional Radiology's 34th Annual Scientific Meeting.
Seaweed and fireflies brew may guide stem cell treatment for peripheral artery disease
An unlikely brew of seaweed and glow-in-the-dark biochemical agents may hold the key to the safe use of transplanted stem cells to treat patients with severe peripheral arterial disease (PAD), according to a team of veterinarians, basic scientists and interventional radiologists at Johns Hopkins.
For old or young dialysis patients, AV fistulas remain pure gold
A new study shows that for those individuals with chronic kidney disease, it doesn't matter if you're young or old: arteriovenous (AV) fistulas remain the gold standard for maintaining access to one's circulatory system to provide life-sustaining dialysis.
Low-dose aspirin does not appear to reduce risk of CV events in patients with diabetes
Low-dose aspirin as primary prevention did not appear to significantly reduce the risk of a combined end point of coronary, cerebrovascular and peripheral vascular events in patients with type 2 diabetes, according to a new study in JAMA.
More Arterial Disease Current Events and Arterial Disease News Articles
 |
Pulmonary Arterial Hypertension and Interstitial Lung Diseases: A Clinical Guide by Robert P. Baughman (Editor), Roberto G. Carbone (Editor), Giovanni Bottino (Editor) Interstitial lung disease (ILD) is a broad category of lung diseases that includes more than 150 disorders characterized by scarring or fibrosis of the lungs. In Pulmonary Arterial Hypertension and Interstitial Lung Disease: A Clinical Guide, renowned experts provide a state-of-the-art overview of the problems seen by physicians in the clinical management of ILDs. Divided into two sections, the first part provides and update on general issues and introduces both interstitial lung disease and associated pulmonary hypertension. A detailed analysis of the pathology of the various interstitial lung diseases is also provided. The second part addresses specific categories of disease. Bronchiolitis, hypersensitivity pneumonitis, and other conditions are covered, and the use of inspiratory and... |
 |
PAD: Peripheral Arterial Disease Part of the award winning public television series Healthy Body/Healthy Mind. Peripheral Arterial Disease or PAD is an often misdiagnosed vascular disease which causes leg pain due to poor circulation, sometimes resulting in years of discomfort for many patients. This program raises awareness of PAD and simple diagnostic testing. If detected in the early stages, patients can be treated successfully and once again, live their lives pain free. |
 |
PAD: Peripheral Arterial Disease Directed By: (c) Information Television Network |
 |
Peripheral Arterial Disease: Applying The New Guidelines in Clinical Practice (NCME Video 859) Also With: Network For Continuing Medical Education (Primary Contributor), Alain Drooz (Primary Contributor) Peripheral arterial disease (PAD) is a highly prevalent disorder that is associated with significant cardiovascular morbidity and mortality. Despite its prevalence and severity, PAD is underdiagnosed and undertreated in primary care practice. In order to address this public health crisis, the American College of Cardiology and the American Heart Association, in collaboration with the nations major vascular societies, released new practice guidelines for the management of patients with PAD. In this video program, Dr. Alain Drooz, a leading vascular specialist, explains how to easily apply the new guidelines for PAD in clinical practice. He reviews the differential diagnosis of PAD, provides strategies for risk reduction and secondary prevention, outlines primary treatment of symptoms of... |
 |
Peripheral Arterial Disease by Robert Dieter (Author), Jr.,Raymond Dieter (Author), III,Raymond Dieter (Author) A complete guide to understanding and treating peripheral arterial disease A Doody's Core Title! " It is almost certainly the most comprehensive collection of material devoted solely to noncardiac arterial health and disease ever assembled....This is a good book with something in it for everyone. It is well written and edited, comprehensive, and very up to date. 3 Stars."--Doody's Review Service Written by a multidisciplinary team of internationally recognized authors, this book delivers an in-depth and practical overview of peripheral arterial disease. It covers all major extracardiac arterial systems and serves as a point-of-care reference for the vascular surgeon, radiologist, vascular internist, and cardiologist. Peripheral Arterial Disease offers... |
 |
Diabetic Foot Lower Extremity Arterial Disease And Limb Salvage by Lippincott Williams & Wilkins Diabetic Foot Lower Extremity Arterial Disease and Limb Salvage : Diabetic Foot Lower Extremity Arterial Disease and Limb Salvage Pub Date: December 2005 Product Type: Print Author/s: Anton N Sidawy MD Understanding tibio-peroneal occlusive disease and its management is vital in treating patients with peripheral vascular disease. Occlusive disease and the resulting ischemia threaten the viability of the lower limb, particularly in diabetics.Edited by widely-respected vascular surgeon Anton N. Sidawy, this textbook explores all aspects of tibio-peroneal disease, including pathophysiology, diagnosis, treatment, and management of the lower extremity after adequate circulation is restored. It examines risk factors, disease distribution, and general management issues... |
 |
ABC of Arterial and Venous Disease (ABC Series) by Richard Donnelly (Editor), Nick J. M. London (Editor) Structural and functional abnormalities of arteries and veins manifest clinically in a broad spectrum of disorders, including aneurysmal disease, atherosclerosis, vasculitis, venous insufficiency, microvascular complications, thrombo-embolism and lower limb ulceration. Many of these are common and/or chronic conditions which present for initial assessment by primary health care workers. This new edition is a practical guide to the most commonly presenting disorders, and provides a structured approach to clinical assessment, investigations and management. The last few years have seen major changes in the use of non-invasive or minimally-invasive techniques, e.g wider use of CT and MR angiography, and increasing use of percutaneous interventions for carotid, lower limb and... |
 |
Lower Extremity Arterial Disease (Clinical Hypertension and Vascular Diseases) by Dennis G. Caralis (Editor), George L. Bakris (Editor) A comprehensive review the state-of-the-art in atherosclerosis of the arteries of the legs and feet. The authors discuss in detail the primary symptom-claudication-an intermittent pain in the leg or foot while walking, its predisposing factors, the current diagnostic methodologies, the impressive advances in the therapeutic armamentarium, and the need to screen for co-existing coronary artery disease. Additional chapters describe cutting-edge noninvasive angiography and vascular flow studies, specific drug therapy for claudication, regression of atherosclerosis therapy, gene therapy, and drug eluting stents for peripheral arterial disease. The authors also examine the epidemiology of LEAD, the effects of smoking and effective smoking cessation programs, its pathogenesis and its... |
 |
Peripheral Arterial Disease Handbook by William R. Hiatt (Editor), Judith Regensteiner (Editor), Alan T Hirsch (Editor) Approximately eight to twelve million individuals in the United States are affected by peripheral arterial disease (PAD). Thus this disease is common and well represented in nearly all adult medical practices. Peripheral arterial diseases include diverse clinical entities that encompass atherosclerotic, aneurysmal, vasospastic, and inflammatory disorders that affect the arteries. The Peripheral Arterial Disease Handbook presents a unique compendium of evidenced-based and expert approaches for the diagnosis and treatment of peripheral arterial diseases, written for all practitioners who care for adults with these disorders. This comprehensive, easy-to-use book presents both epidemiological and pathophysiological data in succinct form, along with a practical clinical review of the diagnosis... |
 |
Contemporary Diagnosis And Management of Peripheral Arterial Disease by William R. Hiatt (Author) This handbook explains the many aspects of peripheral arterial disease (PAD) to aid the physician with the diagnostic process. the natural history of PAD, its clinical presentation and assessment, and the management of intermittent claudication and critical limb ischemia are the key topics addressed. |
| © 2009 BrightSurf.com |