The prevalence of low dose aspirin use for prevention of adverse cardiovascular events and its associated factors among patients with diabetes mellitus: A hospital based cross-sectional study

Abstract

AbstractBackgroundCardiovascular diseases (CVD) are the most common causes of mortality and morbidity among diabetic patients. Aspirin is recommended for primary and secondary prevention of cardiovascular events in patients with diabetics who are eligible for therapy based on active international guidelines. However, these active guidelines are underutilized. Hence, this article helps to assess low dose aspirin use and its associated factors in patients with diabetes mellitus on follow-up at the diabetes clinic of Jimma Medical Center (JMC).MethodA cross-sectional study was conducted among 388 diabetic patients on follow-up at the diabetic clinic of JMC during October 1, 2020 to November 15, 2020. The collected data were cleaned and entered into EpiData version 4.6 then exported to STATA version 16.0 for analysis. Descriptive statistics and multivariable logistic regression was employed to identify the relationship between dependent and independent variables with declaring statistical significance if P value is less than 0.05.ResultOut of the total 388 diabetic patients interviewed, Most of the patients were in the age group of 50-54 (35.8%) with the mean age of 48.8 [48.2, 51.4] years old. About half (48.7%) of them had a history of hypertension. Nearly double of the study participants (47.2%) were utilizing a low dose aspirin. Aspirin was indicated for 80 (20.6%) of the patients despite 21 (26.2%) of them were not using it. It was both indicated and prescribed in 59 (15.2%) of the cases. Older age, longer duration of DM, dyslipidemia, and hypertension were associated with more likely utilization of low dose aspirin.ConclusionAbout half of the DM patients were utilizing low dose aspirin, while only one fifth of them were having indications to do so. Furthermore, one fourth of the patients were not taking low dose aspirin for the prevention of cardiovascular events despite they were supposed to use it. Therefore, these findings suggest a greater need for physicians to carefully assess the indications to prescribe aspirin with a clear explanation of the it’s advantages in these specific patient population. Ultimately, future studies should examine the influence of updating guidelines on clinician behaviors to avoid irrational use of aspirin and the association of changing trends in preventive aspirin use with the development of CVD in patients with DM.