Aspirin and mortality in patients with Diabetes Mellitus sustaining Acute Coronary Syndrome
- Richard M Cubbon, MBChB1,
- Christopher P Gale, PhD1,
- Adil Rajwani, MBChB1,
- Afroze Abbas, MBChB1,
- Christine Morrell, RGN SCM2,
- Raj Das, MD2,
- Julian H Barth, MD3,
- Peter J Grant, MD1,
- Mark T Kearney, MD (m.t.kearney{at}leeds.ac.uk)1 and
- Alistair S Hall, PhD2
- 1Leeds Institute of Genetics, Health & Therapeutics, The LIGHT laboratories, The University of Leeds, Clarendon Way, Leeds; LS2 9JT, United Kingdom
- 2BHF Heart Research Centre, Jubilee Wing, Leeds General Infirmary, Great George Street, Leeds; LS1 3EX, United Kingdom
- 3Department of Clinical Biochemistry and Immunology, Leeds General Infirmary, Great George Street, Leeds; LS1 3EX, United Kingdom
Abstract
Objective: Comparison of mortality reduction associated with secondary prevention in patients with and without diabetes mellitus (DM) after acute coronary syndrome (ACS).
Research design and methods: Cohort study involving 2499 patients with ACS recruited from 11 UK hospitals. Multivariable analysis comparing all cause mortality risk reduction associated with pharmacologic agents in patients with and without DM.
Results: Aspirin was not associated with significant mortality benefit in DM sufferers (95% CI 0.50-1.08); non-diabetic patients derived a 48% mortality reduction (p<0.001). The interaction between DM and aspirin use was statistically significant (p=0.037), indicating patients with DM experience less effective mortality reduction from aspirin use.
Conclusions: Aspirin, but not other secondary prevention agents, is associated with less effective mortality reduction in patients with DM and unstable coronary artery disease.
Footnotes
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- Received September 4, 2007.
- Accepted October 17, 2007.
- Copyright © American Diabetes Association
