title: Aspirin possibly reduces cerebrovascular events in type 2 diabetic patients with higher C-reactive protein level: subanalysis from the JPAD trial.
abstract: OBJECTIVE
  There are few data that demonstrate a significant effect of aspirin therapy for diabetic patients as primary prevention for cardiovascular events. A guideline recommends the use of aspirin as a primary prevention strategy in patients with diabetes who are at increased cardiovascular risk including those who have additional risk factors. To clarify the effect of primary prevention with aspirin therapy on diabetic patients, the relationship between C-reactive protein (CRP) and the incidence of atherosclerotic events was investigated in participants in the Japanese primary prevention of atherosclerosis with aspirin for diabetes (JPAD) trial.
  
  
  METHODS
  We divided the JPAD participants according to the CRP level at enrollment; CRP ≥0.1mg/dl: high CRP group, CRP <0.1mg/dl: low CRP group. The high CRP group consisted of 1131 patients and the low CRP group consisted of 398 patients.
  
  
  RESULTS
  There was no significant difference in the incidence of primary atherosclerotic events between the high CRP group and the low CRP group. Of the atherosclerotic events, the incidence of cerebrovascular events, however, was significantly higher in the high CRP group than in the low CRP group. The incidence of cerebrovascular events was higher in the high CRP group than in the low CRP group in patients without aspirin therapy, although there was no significant difference in the incidence of the cerebrovascular events between the high CRP group and the low CRP group in patients undergoing aspirin therapy.
  
  
  CONCLUSIONS
  Aspirin therapy may reduce cerebrovascular events in diabetic patients with higher CRP. Aspirin therapy could be an additional strategy as primary prevention for diabetic patients with higher CRP.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan; Health Care Center, Kumamoto University, Kumamoto, Japan. Electronic address: yuuki@gpo.kumamoto-u.ac.jp.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Soejima
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nakayama
authors.forename: Sadanori
authors.initials: S
authors.lastname: Okada
authors.forename: Mio
authors.initials: M
authors.lastname: Sakuma
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.forename: Masao
authors.initials: M
authors.lastname: Kanauchi
authors.forename: Naofumi
authors.initials: N
authors.lastname: Doi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Jinnouchi
authors.forename: Seigo
authors.initials: S
authors.lastname: Sugiyama
authors.forename: Masako
authors.initials: M
authors.lastname: Waki
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000368:Aged; D001241:Aspirin / Q000008:administration & dosage*; D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications*; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D001241:Aspirin
keywords: Aspirin; Cardiovascular diseases; Diabetes mellitus; Prevention; Stroke