6 voices in 10 minutes: Aspirin in primary prevention
DOI:
https://doi.org/10.47196/diab.v54i3Sup.281Keywords:
aspirin, diabetesAbstract
6 voices in 10 minutes: Strategies to reduce cardiovascular risk in patients with diabetes mellitus
Aspirin in primary prevention
Acetylsalicylic acid (ASA) is a non-steroidal anti-inflammatory drug (NSAID) that inhibits the cyclo-oxygenases and, subsequently, the production of prostaglandins. The acetylsalicylic acid acetyls covalently the catalytic subunits of COX-1 and COX-2 dimmers, which inhibit irreversibly COX activity.
The intake of acetylsalicylic acid extends bleeding times. This effect is due to the irreversibly acetylation of the COX of the platelets and the permanent suppression of the formation of the TxA2 platelet. ASA reduces in a 20%-25% the risk of vascular events in high risk patients (previous myocardial infarction) (ISIS2 1988-GUSTO, etc.).The reduction of ischemic cardiovascular accidents (CVA) is of a 10%-15% (Anti thrombotic Trialists‘Collaboration et al., 2009). The benefit of the acetylsalicylic acid exceeds clearly the risk of bleeding in secondary prevention of cardiovascular diseases. The problem is situated currently on patients who have not had any atherothrombotic events in Primary Prevention (PP). Different articles have shown a protective tendency under the shadow of gastrointestinal bleeding risk, with numbers needed to treat (NNT) to prevent events close to the numbers needed to generate harm (NNH).
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