American Diabetes Association

Anavekar

Antithrombotic Trialists' Att Collaboration

Ekundayo

H. Jinnouchi

H. Ogawa

H. Soejima

Imai

Jardine

M. Nakayama

M. Waki

Mann

Matsuo

N. Doi

Peto

Pignone

Rossing

S. Okada

S. Sugiyama

S. Uemura

Shiba

Signori

T. Morimoto

Y. Akai

Y. Saito

English

PubMed


                  OBJECTIVE
                  Type 2 diabetes accompanied by renal damage is a strong risk factor for atherosclerotic events. The purpose of this study was to investigate the efficacy of low-dose aspirin therapy on primary prevention of atherosclerotic events in patients with type 2 diabetes and coexisting renal dysfunction.
               
               
                  RESEARCH DESIGN AND METHODS
                  The Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) trial was a prospective, randomized, open-label trial conducted throughout Japan that enrolled 2,539 type 2 diabetic patients without a history of atherosclerotic diseases. Patients were assigned to the aspirin group (81 mg/day or 100 mg/day) or the nonaspirin group and followed for a median of 4.37 years. The primary end points were atherosclerotic events of fatal and nonfatal ischemic heart disease, stroke, and peripheral arterial disease.
               
               
                  RESULTS
                  The analysis included 2,523 patients who had serum creatinine measured. In 1,373 patients with baseline estimated glomerular filtration rate (eGFR) 60–89 mL/min/1.73 m2, the incidence of primary end points was significantly lower in the aspirin group than in the nonaspirin group (aspirin, 30/661; nonaspirin, 55/712; hazard ratio 0.57 [95% CI 0.36–0.88]; P = 0.011). Low-dose aspirin therapy did not reduce primary end points in patients with eGFR ≥90 mL/min/1.73 m2 (aspirin, 9/248; nonaspirin, 11/270; 0.94 [0.38–2.3]) or those with eGFR &amp;lt;60 mL/min/1.73 m2 (aspirin, 29/342; nonaspirin, 19/290; 1.3 [0.76–2.4]). The Cox proportional hazard model demonstrated a significant interaction between mild renal dysfunction (eGFR 60–89 mL/min/1.73 m2) and aspirin (P = 0.02).
               
               
                  CONCLUSIONS
                  These results suggest a differential effect of low-dose aspirin therapy in diabetic patients with eGFR 60–89 mL/min/1.73 m2.
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Yoshihiko Saito

Takeshi Morimoto

Hisao Ogawa

Masafumi Nakayama

Shiro Uemura

Naofumi Doi

Hideaki Jinnouchi

Masako Waki

Hirofumi Soejima

Seigo Sugiyama

Sadanori Okada

Yasuhiro Akai

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Crossref

Diabetes Care

Low-Dose Aspirin Therapy in Patients With Type 2 Diabetes and Reduced Glomerular Filtration Rate

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http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3024334

Low-Dose Aspirin Therapy in Patients With Type 2 Diabetes and Reduced Glomerular Filtration Rate: Subanalysis from the JPAD trial

Low-Dose Aspirin Therapy in Patients With Type 2 Diabetes and Reduced Glomerular Filtration Rate: Subanalysis from the JPAD trial

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