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使用阿司匹林预防 II 型糖尿病患者心血管并发症:一个复杂的故事。

Primary prevention of cardiovascular complications in type II diabetes patients using aspirin: a complicated tale.

机构信息

Department of Cardiology, Chicago Medical School, Chicago, IL, USA.

出版信息

Am J Ther. 2013 May-Jun;20(3):275-8. doi: 10.1097/MJT.0b013e3181afbf17.

Abstract

Diabetes is a disease that affects 23 million in the United States alone. Within the past 20 years, there has been remarkable research performed concerning primary prevention of cardiovascular events in type II diabetes patients. The American Diabetes Association along with a government panel made recommendations that diabetes patients at a high risk of cardiovascular events should be on a low-dose aspirin regimen. However, more recent data show that aspirin has no clinical benefit to the diabetic patient as compared with a control group. Looking at research performed by groups in Japan, the United States, namely, the Primary Prevention Project, and a group in Ireland, we learn that there is no significant difference between diabetes patients who take aspirin and those who do not with respect to cardiovascular events. These studies are criticized by some newer research, and the prevailing thought about them call into question the results they obtained.Furthermore, we learn that many type II diabetes patients are not properly participating in an aspirin regimen or they are overusing aspirin, and these variables appear to confound the situation. One study showed that up to 50% of diabetes patients do not have their diabetes under control and are therefore increasing their risk for a multitude of complications arising from diabetes, including cardiovascular events.Finally, we learn of an upcoming project studying aspirin from Bayer, Inc. Much of the information presented in this article demonstrates the need for more and better research revolving around primary prevention of cardiovascular events in type II diabetes patients using aspirin.

摘要

糖尿病是一种疾病,仅在美国就影响了 2300 万人。在过去的 20 年中,针对 2 型糖尿病患者的心血管事件一级预防已经进行了大量的研究。美国糖尿病协会和一个政府小组建议,心血管事件风险高的糖尿病患者应服用低剂量阿司匹林。然而,最近的数据表明,与对照组相比,阿司匹林对糖尿病患者没有临床益处。从日本、美国的主要预防项目以及爱尔兰的一个小组进行的研究来看,服用阿司匹林的糖尿病患者与不服用阿司匹林的患者在心血管事件方面没有显著差异。这些研究受到一些更新研究的批评,人们对这些研究的结果提出了质疑。此外,我们了解到,许多 2 型糖尿病患者没有正确服用阿司匹林或过度使用阿司匹林,这些变量似乎使情况变得复杂。一项研究表明,多达 50%的糖尿病患者的糖尿病没有得到控制,因此增加了他们患多种糖尿病并发症的风险,包括心血管事件。最后,我们了解到拜耳公司即将开展一项关于阿司匹林的研究。本文介绍的许多信息表明,需要进行更多和更好的研究,以探讨使用阿司匹林预防 2 型糖尿病患者的心血管事件一级预防。

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