Key result
Aspirin use was associated with lower all-cause mortality in type 2 diabetic patients with cardiovascular disease not using NSAIDs (HR 0.81; 95% CI 0.70-0.93), but provided no benefit in NSAID users.
Why the study?
There was little evidence on whether NSAIDs and aspirin interact in secondary cardiovascular prevention in type 2 diabetic patients.
Does aspirin use reduce mortality in type 2 diabetic patients with cardiovascular disease, and is this effect modified by simultaneous NSAID use?
Observational (n=3,600)
Does aspirin use reduce mortality in type 2 diabetic patients with cardiovascular disease, and is this effect modified by simultaneous NSAID use?
Aspirin provides a mortality benefit for secondary cardiovascular prevention in type 2 diabetic patients, but this benefit appears to be negated by the concurrent use of NSAIDs.
Hypothesis-generating for NSAID interaction with aspirin in T2D and CVD; should not yet change practice.
There is little evidence on whether non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin interact in secondary cardiovascular prevention in type 2 diabetic patients. This is an observational study using data from the Action to Control Cardiovascular Risk in Diabetes and Follow-on studies. Hazard ratios (HRs) for mortality with 95% confidence intervals (95% CIs) were calculated using Cox proportional hazard models to compare time to death in patients using and not using aspirin who were simultaneously using or not using NSAIDs. A total of 3600 type 2 diabetic patients with cardiovascular disease were included. During a mean follow-up period of 8.8 years, 948 patients died. After adjustments, the risk of all-cause mortality in patients not using NSAIDs was significantly lower in those using aspirin than in those not using aspirin (HR, 0.81; 95% CI, 0.70-0.93; P = 0.004). The risk in patients using NSAIDs did not differ significantly between the two groups. There was a significant interaction between aspirin use and NSAIDs use. In type 2 diabetic patients with cardiovascular disease, aspirin use was not beneficial for those using NSAIDs.
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Tsujimoto et al. (2019) conducted an observational in Type 2 diabetes with cardiovascular disease (n=3,600). Aspirin vs. No aspirin was evaluated on All-cause mortality (HR 0.81, 95% CI 0.70-0.93, p=0.004). Aspirin use was associated with lower all-cause mortality in type 2 diabetic patients with cardiovascular disease not using NSAIDs (HR 0.81; 95% CI 0.70-0.93), but provided no benefit in NSAID users.
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