Misuse of Aspirin and Associated Factors for the Primary Prevention of Cardiovascular Disease

Abstract

Background: The value of aspirin for primary prevention continues to be debated. Data showing whether aspirin use for primary prevention adheres to established guidelines in real world practice are sparse.Methods: A total of 13,104 patients without cardiovascular diseases (CVD) were selected from the DYS-lipidemia International Study of China, a national survey of patients with dyslipidemia in 2012. The CVD risk of the participants were calculated using the 10-year risk of Ischemic Cardiovascular Diseases model. The misuse of aspirin for primary prevention was defined as having CVD risk <10% with daily aspirin. Multivariate logistic regression models were used to explore risk factors associated with aspirin misuse.Results: The proportion of the patients categorized as low, moderate and high risk for CVD were 52.9, 21.6, and 25.4% respectively. The misuse frequency of aspirin was 31.0% (2,147/6,933) in patients with low risk. The misuse of aspirin increased with aging for both men and women. In the multivariate analysis, the independent risk factors associated with aspirin misuse were hypertension, diabetes mellitus, a family history of premature CVD, and elderly age. Level of total cholesterol is negatively associated with aspirin misuse. Patients from low level hospitals are more likely to be taking aspirin inappropriately. Results remained consistent after including 2,837 patients having 10-year risk for CVD between 10 and <20%.Conclusion: The misuse of aspirin for primary prevention is common in patients having CVD risk <10%. There are important opportunities to improve evidence-based aspirin use for the primary prevention of CVD in Chinese patients.Clinical Trial Registration:https://clinicaltrials.gov/, identifier [NCT01732952].

Use of Antiplatelet and Lipid Lowering Agent Therapies as Primary Cardiovascular Disease Prevention Strategy and their Determinant Factors among Type 2 Diabetes Mellitus Patients in University of Gondar Comprehensive Specialized Hospital, Gondar: A Prospective Cross- sectional Study

“…Being hypertensive was three times more likely to use aspirin than those non-hypertensive patients. This result was in line with the study conducted in Spain (33) and China (31) in which hypertensive patients were two times and three times more likely to use aspirin respectively. The reason behind this could be because the presence of hypertension was a major risk factor for ASCVD (7) which prone the clinicians to use aspirin for PCVDP.…”

“…According to this study, about 9.4% of study participants were using antiplatelet as PCVDP. This study result is comparable with the study conducted in Spain (6.0%) while it is low as compared with use of antiplatelet in the United State (20%), China (38.6%) and Colombia (44.2%), respectively (30)(31)(32)(33). Some reasons might account for the low prevalence of prescribing aspirin or other antiplatelet medications.…”

“…Even though initiation of antiplatelet was low (9.4%), all the antiplatelet started for PCVDP were inappropriately initiated. This might be due to inappropriate risk score prediction for the prevention of CVD, which was a common reason for misuse of aspirin in a study conducted in China (31). Hence, administration of aspirin for low, moderate and high risk patients has low bene t and outweighs the risks of signi cant bleeding and Reye syndrome (12).…”

A Cross-Sectional Study on the Prevalence of Self-Prescribed Aspirin Use for Prevention of Adverse Ischemic Vascular Events Among Moderate-Risk Individuals: A Single Center Study

“…Based on their accounts, 61.7% of older American patients with diabetes mellitus (DM) were aspirin users whereas 42.2% of those without DM were also reported to be taking the medication. The prevalence of unwarranted use of aspirin in our study was relatively low compared to a study by Chen et al [ 12 ]. According to their reports, the misuse of aspirin has been reported by 31% of patients who were at low risk of cardiovascular events while the overall prevalence of aspirin use was 38.6% which was similarly documented among Irish patients with CVD [ 13 ].…”

Aspirin in diabetic patients at primary prevention: insights of the VITAL cohort

“…It is important to stress that patients treated with aspirin had high frequency of cardiovascular risk factors, such as older age, male gender, hypertension, and smoking habits. Data from diabetes vs no diabetes are concordant with literature and support the increased risk of cardiovascular events associated with diabetes [1], and at least partially explain the willingness to prescribe aspirin in these patients [10]. However, the magnitude of risk increase with diabetes was not high as previously reported [4], which can be related to the standard practices for care of cardiovascular risk factors.…”