title: Lack of effect of aspirin in primary CV prevention in type 2 diabetic patients with nephropathy: results from 8 years follow-up of NID-2 study.
abstract: The risk-to-benefit ratio for the use of low dose of aspirin in primary cardiovascular (CV) prevention in patients with diabetes mellitus remains to be clarified. We assessed the effect of aspirin on risk of CV events in type 2 diabetic patients with nephropathy, in order to verify the usefulness of Guidelines in clinical practice. We carried out a prospective multicentric study in 564 patients with type 2 diabetic nephropathy free of CV disease attending outpatient diabetes clinics . A total of 242 patients received antiplatelet treatment with aspirin 100 mg/day (group A), and 322 were not treated with antiplatelet drugs (group B). Primary end point was the occurrence of total major adverse cardio-vascular events (MACE). Secondary end points were the relative occurrence of fatal MACE. The average follow-up was 8 years. Total MACE occurred in 49 patients from group A and in 52 patients from group B. Fatal MACE occurred in 22 patients from group A and in 20 from group B; nonfatal MACE occurred in 27 patients from group A and in 32 patients from group B. Kaplan-Meier analysis did not show a statistically significant difference of cumulative MACE between the two groups. A not statistically significant difference in the incidence of both fatal (p = 0.225) and nonfatal CV events (p = 0.573) between the two groups was observed. These results were confirmed after adjustment for confounders (HR for MACE 1.11, 95 % CI 0.91-1.35). These findings suggest that low dose of aspirin is ineffective in primary prevention for patients with nephropathy.
authors.affiliation: Department of Internal and Experimental Medicine "Magrassi-Lanzara", Second University of Naples, Via F. Petrarca, 64, 80122, Naples, Italy, ferdinando.sasso@unina2.it.
authors.forename: Ferdinando Carlo
authors.initials: FC
authors.lastname: Sasso
authors.forename: Raffaele
authors.initials: R
authors.lastname: Marfella
authors.forename: Antonio
authors.initials: A
authors.lastname: Pagano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Porta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Signoriello
authors.forename: Nadia
authors.initials: N
authors.lastname: Lascar
authors.forename: Roberto
authors.initials: R
authors.lastname: Minutolo
authors.forename: Ornella
authors.initials: O
authors.lastname: Carbonara
authors.forename: Marcello
authors.initials: M
authors.lastname: Persico
authors.forename: Federico
authors.initials: F
authors.lastname: Piscione
authors.forename: Luca
authors.initials: L
authors.lastname: De Nicola
authors.forename: Roberto
authors.initials: R
authors.lastname: Torella
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Paolisso
mesh_terms: D000368:Aged; D001241:Aspirin / Q000008:administration & dosage*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000150:complications*; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011322:Primary Prevention; D011446:Prospective Studies; D018570:Risk Assessment
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin