Influence of Antiplatelet Therapy on Cardiovascular Disease Prevention among Type 2 Diabetic Patients in Thailand
LC01-LC05
Correspondence
Dr. Wongsa Laohasiriwong,
Faculty of Public Health, Khon Kaen University, Muang, Khon Kaen, 40002, Thailand.
E-mail: drwongsa@gmail.com
Introduction: Cardiovascular Disease (CVD) is globally known as a common disease for diabetic patients. Antiplatelet therapy is a key pharmacological method to prevent and treat CVD. However, it has not been conclusive whether antiplatelet could significantly reduce the risk of CVD. An evaluating influence of antiplatelet therapy among Thai diabetics may be administered as a functional management in the future.
Aim: To investigate the effect of antiplatelet therapy for CVD prevention in type 2 diabetic patients in Thailand.
Materials and Methods: A cross-sectional study was investigated on 24,992 cases of Type 2 Diabetes (T2DM) and T2DM with Hypertension (HT) recorded under the program “An assessment on Quality of Care among Patients Diagnosed with T2DM and Hypertension Visiting Hospitals of the Ministry of Public Health and the Bangkok Metropolitan Administration, Thailand” in the year 2012. Among these cases, 10,799 participants were treated with antiplatelet drug whereas, 14,193 participants had no history of this treatment. Patients whose age over 30 years and attended a hospital for their treatments more than one year were recruited. CVD incidence was investigated in both who were treated with antiplatelet drug during one year preceding the data collection and those who were not treated. However, other factors, such as sex, age, period of having the disease, Body Mass Index (BMI), HbA1c level, cholesterol (total, LDL-C, HDL-C), systolic blood pressure and diastolic blood pressure were also recorded. Descriptive statistics with multiple logistic regression and 95% CI were used for analysis.
Results: Total of 24,992 cases of T2DM and T2DM with HT were recruited for analysis. The final model of the multiple logistic regression observed that T2DM who did not obtain antiplatelet therapy had a significantly higher risk of CVD (ORadj=4.35, 95% CI=3.89 to 4.87, p-value <0.001). Other significant co-variates were found including duration of disease ≥10 yrs (ORadj=1.30 95% CI 1.16 to1.44 p-value <0.001), serum creatinine >1.2 mg/dL (ORadj=1.45, 95% CI=1.31 to 1.61, p-value <0.001) and latest systolic blood pressure >120 mmHg (ORadj=1.38, 95% CI 1.23 to 1.55, p-value <0.001) and had HDL-C <40 mg/dL (ORadj=1.25, 95% CI=1.12 to 1.40, p-value <0.001).
Conclusion: Low-dose antiplatelet therapy was significantly associated with decreasing the incidence of CVD. Whereas the duration of disease, serum creatinine, systolic blood pressure and HDL-C were found to be risk factors of CVD.