 |
|
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 RSSLow-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.
Brush your teeth to reduce the risk of heart disease
Heart disease is the leading cause of death worldwide. However, many people with cardiovascular disease have none of the common risk factors such as smoking, obesity and high cholesterol.
Lowering cholesterol early in life could save lives
With heart disease maintaining top billing as the leading cause of death in the United States, a team of University of California, San Diego School of Medicine physician-researchers is proposing that aggressive intervention to lower cholesterol levels as early as childhood is the best approach available today to reducing the incidence of coronary heart disease.
Sexual dissatisfaction in postmenopausal women not linked to cardiovascular disease
Although sexual dysfunction in some men is predictive of cardiovascular disease, this association has never been examined in women.
Decreased sexual satisfaction is not associated with cardiovascular disease in postmenopausal women
Researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) and collaborators nationwide have found that decreased sexual satisfaction in postmenopausal women, is not clearly associated with cardiovascular disease.
Kidney donor age linked to aortic siffening
Transplantation of kidneys from older donors is followed by increased stiffening of the recipient's aorta-which may help to explain the higher rates of cardiovascular disease and death in patients receiving kidneys from "expanded criteria" donors, reports a study in the April Journal of the American Society of Nephrology.
Genetic mutation found in peripheral artery disease
The finding, appearing online in the journal Circulation, is the first to document a genetic mutation linked to PAD. Although the work was done in mice, researchers say it is likely to give them new insight into how PAD develops and progresses in humans.
Study looks at off-label use of biliary stents
Although approved by the U.S. Food and Drug Administration as a palliative treatment for cancer patients who have developed bile-duct obstructions, biliary stents are sometimes used "off-label" for the treatment of peripheral vascular disease (PVD).
Cardiovascular disease death rates decline, but risk factors still exact heavy toll
Cardiovascular disease (CVD) death rates are declining, but CVD is still the No. 1 cause of death in the United States, and risk factor control remains a challenge for many, according to the most recent data from the American Heart Association's Heart Disease and Stroke Statistics - 2008 Update.
Waist-to-hip ratio may better predict cardiovascular risk than body mass index
In a study to be published in the Aug. 21 issue of the Journal of the American College of Cardiology, investigators at UT Southwestern Medical Center found that people with a larger waist-to-hip ratio may be at increased risk for heart disease.
More Arterial Disease Current Events and Arterial Disease News Articles
 | Peripheral Arterial Disease Handbook 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... |
 | Peripheral Arterial Disease (Key Diseases) (Key Diseases) (Key Diseases) Here s a complete resource for general internists on one of the most under-diagnosed conditions in internal medicine, Peripheral Arterial Disease (PAD)! This new book is a concise and practical guide to the diagnosing and treatment methods of PAD. For quick reference, each chapter begins by listing the key questions that will be answered, and ends with a brief summary of what was... |
 | Lower Extremity Arterial Disease (Clinical Hypertension and Vascular Diseases) 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... |
 | Peripheral Arterial Disease (Contemporary Cardiology) Boston Univ., MA. Text provides a detailed account of the medical, surgical, and radiological aspects of peripheral arterial obstructive diseases. Features a discussion of endovascular drug therapies, clinical evaluation of claudication, and acute and chronic limb ischemia. Extensively referenced. DNLM: Peripheral Vascular... |
 | Pulmonary Arterial Hypertension and Interstitial Lung Diseases: A Clinical Guide 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... |
 | Contemporary Diagnosis And Management of Peripheral Arterial Disease by William R. Hiatt |
| Peripheral Arterial Disease; Questions to Ask.: An article from: NWHRC Health Center - Peripheral Arterial Disease This digital document is an article from NWHRC Health Center - Peripheral Arterial Disease, published by National Women's Health Resource Center on March 16, 2005. The length of the article is 637 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can... | |
 | ABC of Arterial and Venous Disease (ABC Series) This slide set compiles all the figures from within the BMJ's book ABCof Arterial and Venous Disease onto one CD-ROM. This ABC is a practicalguide to the commonly presenting arterial and venous disorders. It providesup to date coverage of the diagnosis and investigation of the diseases, aswell as clinical management chapters and strategies for prevention ofcomplications. The slide set will... |
 | Peripheral Arterial Disease by Robert Dieter, Jr.,Raymond Dieter, III,Raymond Dieter A complete guide to understanding and treating peripheral arterial disease . . 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... |
| 100 Q&A About Peripheral Arterial Disease (100 Questions & Answers about . . .) by Emile R. Mohler 100 Questions & Answers About Peripheral Arterial Disease offers authoritative, up-to-date, practical answers about the diagnosis, treatment and support. The book is an invaluable resource for anyone coping with the physical and emotional turmoil of this... |
| © 2009 BrightSurf.com |