Aspirin and mortality in patients with diabetes sustaining acute coronary syndrome.
OBJECTIVE
We sought to compare mortality reduction associated with secondary prevention in patients with and without diabetes after acute coronary syndrome (ACS).


METHODS
We conducted a cohort study involving 2,499 patients with ACS recruited from 11 U.K. hospitals. Multivariable analysis comparing all-cause mortality risk reduction associated with pharmacologic agents in patients with and without diabetes.


RESULTS
Aspirin was not associated with significant mortality benefit in diabetes sufferers (95% CI 0.50-1.08); nondiabetic patients derived a 48% mortality reduction (P < 0.001). The interaction between diabetes and aspirin use was statistically significant (P = 0.037), indicating that patients with diabetes experience less effective mortality reduction from aspirin use.


CONCLUSIONS
Aspirin, but not other secondary prevention agents, is associated with less effective mortality reduction in patients with diabetes and unstable coronary artery disease.
Cubbon
Richard M
RM
Leeds Institute of Genetics, Health & Therapeutics, LIGHT Laboratories, University of Leeds, Leeds, UK.
Gale
Christopher P
CP
Rajwani
Adil
A
Abbas
Afroze
A
Morrell
Christine
C
Das
Raj
R
Barth
Julian H
JH
Grant
Peter J
PJ
Kearney
Mark T
MT
Hall
Alistair S
AS
D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000401:mortality; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use*; D015331:Cohort Studies; D003925:Diabetic Angiopathies / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000401:mortality; D008297:Male; D015999:Multivariate Analysis; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin