Evaluation of low-dose aspirin for primary prevention of ischemic stroke among patients with diabetes: a retrospective cohort studyopen access
- Authors
- Kim, Ye-Jee; Choi, Nam-Kyong; Kim, Mi-Sook; Lee, Joongyub; Chang, Yoosoo; Seong, Jong-Mi; Jung, Sun-Young; Shin, Ju-Young; Park, Ji-Eun; Park, Byung-Joo
- Issue Date
- Feb-2015
- Publisher
- BMC
- Keywords
- Aspirin; Diabetes mellitus; Ischemic stroke; Health insurance claims database; Retrospective cohort study
- Citation
- DIABETOLOGY & METABOLIC SYNDROME, v.7
- Journal Title
- DIABETOLOGY & METABOLIC SYNDROME
- Volume
- 7
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/69372
- DOI
- 10.1186/s13098-015-0002-y
- ISSN
- 1758-5996
1758-5996
- Abstract
- Background: Low-dose aspirin is recommended to reduce the risk of cardiovascular disease. However, the questions with regard to primary prevention have been raised among patients with diabetes. We evaluated low-dose aspirin use for preventing ischemic stroke in patients with diabetes using a national health insurance database. Methods: Using data from the Korean Health Insurance Review and Assessment Service database from January 1, 2005, through December 31, 2009, a population-based retrospective cohort study was conducted with incident patients with diabetes aged 40 to 99 years old with the initial use of low-dose aspirin during the index period from January 1, 2006 to December 31, 2007. We matched each low-dose aspirin user to one non-user using a propensity score. The Cox proportional hazards model was used to compare the risk of hospitalization for ischemic stroke in users and nonusers of low-dose aspirin until December 31, 2009. Results: Out of 261,065 incident patients with diabetes, 15,849 (6.2%) were low-dose aspirin users. Compared to non-users, the adjusted hazard ratio (95% confidence interval) of low-dose aspirin users for hospitalization due to ischemic stroke was 1.73 (95% CI; 1.41-2.12). In a sensitivity analysis of study subjects with more than 1 year follow-up periods, slightly higher adjusted hazard ratio (1.97, 95% CI; 1.51-2.62) was observed. In the subgroup analyses, there were no significant changes in the risk of hospitalization for ischemic stroke irrespective of gender, age, or comorbidity. Conclusions: In this study of patients with diabetes, the use of low-dose aspirin showed an increased risk of hospitalization for ischemic stroke. These results suggest that low-dose aspirin use for the primary prevention of ischemic stroke should be reconsidered in patients with diabetes.
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