Use of antiplatelet therapy in a diabetic outpatient service of a large urban public hospital.
OBJECTIVE
Cardiovascular disease is the most important cause of mortality in type 2 diabetes. Aspirin treatment is effective in diabetic patients with cardiovascular disease and it does not significantly increase the risk of retinal haemorrhage, gastrointestinal bleeding or hemorrhagic stroke. The American Diabetes Association (ADA) recommends the use of aspirin in all adult patients with diabetes and macrovascular disease, and suggests to start treatment with aspirin for primary prevention in diabetic patients >or=40 years of age and with one or more other cardiovascular risk factors in the absence of specific contraindications.


METHODS
In this observational retrospective study, we have selected from our database (17,732 clinical reports) all the type 2 diabetic patients 41--80 years of age, who had at least one visit to our outpatient service in the following two periods: A (from 1 July 1995 to 30 June 1996) and B (from 1 July 2002 to 30 June 2003), then analysed the patient-records for prescription of antiplatelet agents.


RESULTS
Our analysis has shown that antiplatelet agents were prescribed to 15% of the type 2 diabetic patients in period A (10.8% and 53.4% -- primary and secondary prevention, respectively) and to 22.8% of the patients in period B (19.1% and 60.5% -- primary and secondary prevention, respectively).


CONCLUSIONS
Patients with type 2 diabetes and high cardiovascular risk are not always under antiplatelet treatment despite the ADA recommendations, particularly for primary prevention. However, our data show an increased trend in prescriptions from 1997, when the first ADA specific guidelines for aspirin therapy were published.
Bruno
Alberto
A
Diabetic Outpatient Department, San Giovanni Battista di Torino Hospital, Corso Bramante, 88, 10126 Turin, Italy. abruno@molinette.piemonte.it
Grassi
Giorgio
G
Dani
Franco
F
Degiovanni
Mariella
M
Maghenzani
Giorgio
G
Pagano
Gianfranco
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011322:Primary Prevention / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin