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

Abstract

Abstract Background: Patients with type 2 diabetes mellitus have two to four times increased risk of cardiovascular events compared with those without diabetes. Anti-platelet therapy and lipid lowering therapies have a significant contribution to prevent primary cardiovascular disease to achieve optimal patient outcomes. Objective: This study aimed to assess the use of antiplatelet and lipid lowering agent therapies as primary cardiovascular disease prevention strategies and their determinant factors among type 2 diabetes mellitus patients in University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. Methods: A prospective cross sectional study was conducted among 405 type 2 diabetes mellitus patients selected using a systematic random sampling method. Semi-structured questionnaire and data abstraction format were used for data collection. The data was collected from May 1 – July 30, 2022. The data was entered into Epidata version 3 and exported to SPSS version 25.0 statistical packages. Multivariable binary logistic regression analysis was done for identifying factors associated with use antiplatelet and lipid lowering agent. Statistical significance was declared at 95% confidence interval. Result:Out of 405 study participants, the majority of study participants 301 (74.3%) had low (<10%) 10-year cardiovascular disease risk and moderate risk was 75 (18.5%). Statin was used for 180 (44.4%) of the study participants. While 81mg aspirin was used for 38 participants. About 58.8% using statin appropriately while 89.9% of them using aspirin appropriately. Ages between 65 - 69 years old (AOR = 3.76, 95% CI: 1.33- 10.61), taking alcohol (AOR = 0.38, 95%: 0.23 - 0.64), being hypertensive (AOR = 2.30, 95%CI: 1.38-3.86) and using two or more glucose lowering agent (AOR = 4.60, 95%CI: 2.72- 7.78) were significantly associated with use of statin. On the other hand, use of more than one glucose lowering agent (AOR = 4.36, 95%CI: 1.64 - 11.61) and being hypertensive (AOR = 3.34, 95%CI: 1.24 - 8.96) were associated with the use of aspirin. Conclusion:The appropriate indication of lipid lowering agent was low. So, this population is at high potential risk for the development cardiovascular disease and predisposed to unwanted medication side effects. Also, aspirin was used for 10% of patients who were scored under high risk, which implicates these populations are at high risks for bleeding and Reye syndrome, despite the low benefit. These results emphasize the necessity of considering the cardiovascular disease risk of the patients and apply an appropriate measure for primary prevention.