Sabitha P, Kamath Asha, Adhikari Prabha M
Int J Diabetes Dev Ctries. 2008 Apr;28(2):51-3. doi: 10.4103/0973-3930.43099.
To evaluate the prescription of aspirin for primary and secondary prevention of cardiovascular disorders in diabetic patients, in the light of American Diabetes Association guidelines.
In this retrospective analysis, presence of any cardiovascular disease or cardiovascular disease risk factor as defined in American Diabetes Association guidelines and the use of aspirin and other medication data were extracted from the case files of 100 patients with type 2 diabetes mellitus visiting two teaching hospitals.
Of 100 patients studied, 58% were men and 42% women and all were >/= 40 years of age. 45% had at least one cardiovascular disease and all (100%) were on aspirin for secondary prevention; 45% had one or more risk factors, of which 11% (05/45) had aspirin prescribed for primary prevention; remaining 10% had neither risk factors nor cardiovascular disease (but age >/= 40 years) and no aspirin documentation. Reasons for not using aspirin/antiplatelet drug were not recorded.
American Diabetes Association recommendations for aspirin use for secondary prevention of cardiovascular diseases were strictly adhered to, in contrast to that for primary prevention. Under-prescription of aspirin could be attributed to the physicians' concern about the burden of poly-pharmacy and toxic effects of aspirin on long-term use. Extensive efforts are necessary to enhance aspirin use in this regard.
根据美国糖尿病协会指南,评估阿司匹林在糖尿病患者心血管疾病一级和二级预防中的处方情况。
在这项回顾性分析中,从两家教学医院就诊的100例2型糖尿病患者的病历中提取美国糖尿病协会指南中定义的任何心血管疾病或心血管疾病危险因素的存在情况以及阿司匹林和其他药物使用数据。
在研究的100例患者中,58%为男性,42%为女性,所有患者年龄均≥40岁。45%的患者至少患有一种心血管疾病,所有患者(100%)均服用阿司匹林进行二级预防;45%的患者有一个或多个危险因素,其中11%(05/45)的患者被开具阿司匹林用于一级预防;其余10%的患者既无危险因素也无心血管疾病(但年龄≥40岁)且无阿司匹林用药记录。未记录不使用阿司匹林/抗血小板药物的原因。
与一级预防相比,严格遵循了美国糖尿病协会关于阿司匹林用于心血管疾病二级预防的建议。阿司匹林处方不足可能归因于医生对多重用药负担以及阿司匹林长期使用毒性作用的担忧。在这方面需要做出广泛努力以增加阿司匹林的使用。