Aspirin use for cardiovascular disease prevention in the uninsured population

Abstract

Introduction: Aspirin is an effective anti-inflammatory and antiplatelet agent as an irreversible inhibitor of cyclooxygenase. In 2016, the U.S. Preventive Services Task Force recommended aspirin for primary prevention of cardiovascular disease in patients aged 50–69 years with a 10% or greater 10-year cardiovascular disease risk. Current guidelines for patients with prior myocardial infarction or coronary artery disease recommend aspirin use for the secondary prevention of cardiovascular disease. Due to the lack of literature describing adherence to these recommendations in the uninsured patient population, we studied aspirin use for cardiovascular disease prevention in free medical clinics. Methods: We conducted a cross sectional study of uninsured patients who visited nine free medical clinics in 2016–2017. Data from the records of 8857 patients were combined into a database for analysis. 10-year Framingham risk scores for coronary artery disease were calculated for the 50–69-year-old population to evaluate which patients qualified for aspirin usage. Aspirin use was assessed for patients with prior myocardial infarction or coronary artery disease. Results: In total, 1443 patients met the criteria to take aspirin for primary prevention of cardiovascular disease, but just 17% of these patients aged 50–59 years were on the medication. About 15% of the patients aged 60–69 years were taking aspirin. Of the 297 patients who had prior myocardial infarction or coronary artery disease, 50% were taking aspirin for secondary prevention. Conclusion: Among the uninsured population, there are low rates of aspirin use for risk reduction of cardiovascular disease. This study demonstrates that improvements are needed to increase adherence to current guidelines and address barriers uninsured patients may face in maintaining their cardiovascular health.

Streptomyces sp. Strain PBR11, a Forest-Derived Soil Actinomycetia with Antimicrobial Potential

“…Campestanol ( 83 ), SM(d18:0/0:0) ( 84 ), ethoxyquin ( 85 , 86 ), phendimetrazine ( 87 ), 10-deoxymethymycin ( 88 ), anandamide (20:2, n -6) ( 89 ), and miltefosine ( 90 ) have hypocholesterolemic, cell signaling, antioxidant, anticarcinogenic, anorexigenic, antibacterial, fatty acid neurotransmitter, and antileishmanial effects, while no bioactivity has been reported for 11-amino-undecanoic acid, d -pantetheine 4′-phosphate, and 3-hydroxytetradecanedioic acid. The biologically active compounds diethylcarbamazine, acetylsalicylic acid (aspirin), 2-propyl-9 Z -octadecenoic acid, and oleandrin ( 72 , 91 – 95 ) detected in the bioactive fraction of PBR11Fr-2 exhibited anti-inflammatory effects, nonsteroidal anti-inflammatory action, antiplasmodial activity, anticancer effects, novel antiviral activity, and anorexigenic effects. However, there is no bioactivity reported for 12,14-pentacosadiynoic.…”

Retrospective Study of Appropriate Primary Prevention in Postmenopausal Women Presenting with a Major Adverse Cardiovascular Endpoint (MACE)

“…This may be a contributing factor as to why uninsured patients do not use primary prevention therapies appropriately as they do not have a provider evaluating their need for these therapies as often as someone with a PCP may be. A cross-sectional study conducted by Liu et al evaluated the use of aspirin for primary prevention in the uninsured patient population [ 15 ]. Out of the 1443 patients that met the criteria for aspirin therapy according to the AHA/ACC guidelines, only 17% of patients aged 50–59 years and 15% of patients aged 60–69 years were taking aspirin therapy.…”

Stability evaluation of Acetylsalicylic acid in commercial Aspirin tablets available in the Iraqi market ‎

“…Aspirin is now known for over a century for its analgesic, anti-inflammatory, and antipyretic action. Although these actions were superseded by other newer non-steroidal antiinflammatory agents, aspirin still has widespread use as an antiplatelet agent to prevent the formation of thrombi [2,3]. Analysis of the active pharmaceutical ingredients by different methods was a fundamental part of the quality control measures required to ensure both amounts and stability of the active compounds until the product reaches its expiry date, in addition to the ability of these methods to distinguish between the active compound and its degradation products [4].…”