Statin but not Aspirin Treatment is Associated with Reduced Cardiovascular Risk in Patients with Diabetes without Obstructive Coronary Artery Disease

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Statin but not Aspirin Treatment is Associated with Reduced Cardiovascular Risk in Patients with Diabetes without Obstructive Coronary Artery Disease. / Olesen, Kevin K W; Heide-Jørgensen, Uffe; Thim, Troels; Thomsen, Reimar W; Bøtker, Hans Erik; Sørensen, Henrik T; Maeng, Michael.

I: European heart journal. Cardiovascular pharmacotherapy, 14.05.2021.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{defbec54420b407e841fdcce8da4d18c,
title = "Statin but not Aspirin Treatment is Associated with Reduced Cardiovascular Risk in Patients with Diabetes without Obstructive Coronary Artery Disease",
abstract = "AIMS: Patients with diabetes and no obstructive coronary artery disease (CAD) as assessed by coronary angiography (CAG) are frequently treated with aspirin and statins. We examined the effectiveness of aspirin and statin treatment on cardiovascular and bleeding incidence in patients with diabetes and absent obstructive CAD.METHODS AND RESULTS: The study included patients with diabetes and absent obstructive CAD as assessed by CAG from 2003 to 2016 in Western Denmark. We stratified patients by aspirin and statin treatment within 6 months after CAG in two separate analyses. Outcomes were MACE (major adverse cardiovascular events, a composite of myocardial infarction, ischaemic stroke, and death) and bleeding (aspirin only). To account for confounding, we used propensity score-based weights to estimate the inverse probability of treatment-weighted hazard ratios (HRIPTW). We included 4,124 patients with diabetes but without CAD as assessed by CAG, among whom 2,474 (60%) received aspirin and 2,916 (71%) received statin treatment within 6 months following CAG. Median follow-up was 4.9 years. Aspirin did not reduce 10-year MACE (21.3% vs 21.8%, HRIPTW 1.01, 95% confidence interval (CI) 0.82-1.25), all-cause death (HRIPTW 0.96, 95% CI 0.74-1.23), or bleeding (HRIPTW 0.95, 95% CI 0.73-1.23), compared to those not receiving aspirin treatment. Statin treatment reduced MACE (25% vs. 37%, HRIPTW 0.58, 95% CI 0.48-0.70) compared to those not receiving statin treatment.CONCLUSION: Among patients with diabetes and no obstructive CAD, aspirin neither reduced MACE nor increased bleeding. In contrast, statin treatment was associated with a major reduction in risk of MACE.",
author = "Olesen, {Kevin K W} and Uffe Heide-J{\o}rgensen and Troels Thim and Thomsen, {Reimar W} and B{\o}tker, {Hans Erik} and S{\o}rensen, {Henrik T} and Michael Maeng",
note = "{\textcopyright} Published on behalf of the European Society of Cardiology. All rights reserved. {\textcopyright} The Author 2021. For permissions, please email: journals.permissions@oup.com.",
year = "2021",
month = may,
day = "14",
doi = "10.1093/ehjcvp/pvab040",
language = "English",
journal = "European heart journal. Cardiovascular pharmacotherapy",
issn = "2055-6837",
publisher = "Oxford University Press",

}

RIS

TY - JOUR

T1 - Statin but not Aspirin Treatment is Associated with Reduced Cardiovascular Risk in Patients with Diabetes without Obstructive Coronary Artery Disease

AU - Olesen, Kevin K W

AU - Heide-Jørgensen, Uffe

AU - Thim, Troels

AU - Thomsen, Reimar W

AU - Bøtker, Hans Erik

AU - Sørensen, Henrik T

AU - Maeng, Michael

N1 - © Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2021. For permissions, please email: journals.permissions@oup.com.

PY - 2021/5/14

Y1 - 2021/5/14

N2 - AIMS: Patients with diabetes and no obstructive coronary artery disease (CAD) as assessed by coronary angiography (CAG) are frequently treated with aspirin and statins. We examined the effectiveness of aspirin and statin treatment on cardiovascular and bleeding incidence in patients with diabetes and absent obstructive CAD.METHODS AND RESULTS: The study included patients with diabetes and absent obstructive CAD as assessed by CAG from 2003 to 2016 in Western Denmark. We stratified patients by aspirin and statin treatment within 6 months after CAG in two separate analyses. Outcomes were MACE (major adverse cardiovascular events, a composite of myocardial infarction, ischaemic stroke, and death) and bleeding (aspirin only). To account for confounding, we used propensity score-based weights to estimate the inverse probability of treatment-weighted hazard ratios (HRIPTW). We included 4,124 patients with diabetes but without CAD as assessed by CAG, among whom 2,474 (60%) received aspirin and 2,916 (71%) received statin treatment within 6 months following CAG. Median follow-up was 4.9 years. Aspirin did not reduce 10-year MACE (21.3% vs 21.8%, HRIPTW 1.01, 95% confidence interval (CI) 0.82-1.25), all-cause death (HRIPTW 0.96, 95% CI 0.74-1.23), or bleeding (HRIPTW 0.95, 95% CI 0.73-1.23), compared to those not receiving aspirin treatment. Statin treatment reduced MACE (25% vs. 37%, HRIPTW 0.58, 95% CI 0.48-0.70) compared to those not receiving statin treatment.CONCLUSION: Among patients with diabetes and no obstructive CAD, aspirin neither reduced MACE nor increased bleeding. In contrast, statin treatment was associated with a major reduction in risk of MACE.

AB - AIMS: Patients with diabetes and no obstructive coronary artery disease (CAD) as assessed by coronary angiography (CAG) are frequently treated with aspirin and statins. We examined the effectiveness of aspirin and statin treatment on cardiovascular and bleeding incidence in patients with diabetes and absent obstructive CAD.METHODS AND RESULTS: The study included patients with diabetes and absent obstructive CAD as assessed by CAG from 2003 to 2016 in Western Denmark. We stratified patients by aspirin and statin treatment within 6 months after CAG in two separate analyses. Outcomes were MACE (major adverse cardiovascular events, a composite of myocardial infarction, ischaemic stroke, and death) and bleeding (aspirin only). To account for confounding, we used propensity score-based weights to estimate the inverse probability of treatment-weighted hazard ratios (HRIPTW). We included 4,124 patients with diabetes but without CAD as assessed by CAG, among whom 2,474 (60%) received aspirin and 2,916 (71%) received statin treatment within 6 months following CAG. Median follow-up was 4.9 years. Aspirin did not reduce 10-year MACE (21.3% vs 21.8%, HRIPTW 1.01, 95% confidence interval (CI) 0.82-1.25), all-cause death (HRIPTW 0.96, 95% CI 0.74-1.23), or bleeding (HRIPTW 0.95, 95% CI 0.73-1.23), compared to those not receiving aspirin treatment. Statin treatment reduced MACE (25% vs. 37%, HRIPTW 0.58, 95% CI 0.48-0.70) compared to those not receiving statin treatment.CONCLUSION: Among patients with diabetes and no obstructive CAD, aspirin neither reduced MACE nor increased bleeding. In contrast, statin treatment was associated with a major reduction in risk of MACE.

U2 - 10.1093/ehjcvp/pvab040

DO - 10.1093/ehjcvp/pvab040

M3 - Journal article

C2 - 33989394

JO - European heart journal. Cardiovascular pharmacotherapy

JF - European heart journal. Cardiovascular pharmacotherapy

SN - 2055-6837

ER -