[Use of anti-aggregant drugs in primary and secondary cardiovascular prevention in diabetics in town and country in the León area]

Abstract

Objectives: To find how many diabetics should receive anti-aggregant treatment according to the recommendations made since 2001 by the American Diabetes Association (ADA), how many cardiovascular events could be avoided by 100 mg daily of acetylsalicylic acid (ASA), and the cost per event avoided by this measure.

Design: Transversal, descriptive, multi-centre study. SETTING. Primary care. 8 clinics in 5 health districts (3 rural, 1 semi-urban, 4 urban) in the León area. PARTICIPANTS. Diabetics aged 14 or over diagnosed through the ADA criteria since 1997. MAIN MEASUREMENTS. Audit of clinical records, collecting age and sex, the presence of the criteria of the ADA for anti-aggregation, the existence of established cardiovascular disease (CVD) and the anti-aggregant treatment patients receive. RESULTS. 544 diabetics. 97.2% (95% CI, 95.8%-98.6%) comply with anti-aggregation criteria. 101 had established CVD (18.6%; CI, 15.3%-21.9%); 77.2% received anti-aggregants (CI, 73.7%-80.7%).428 had no CVD and did have anti-aggregation criteria (78.7%; CI, 75.3%-82.1%); 9.3% (CI, 6.9%-11.7%) received treatment. CONCLUSIONS. There was basically little follow-up of the ADA anti-aggregation recommendations in primary prevention. Treatment of our diabetics with 100 mg/day of ASA would avoid 7.64 cardiovascular events in five years (CI, 5.56-9.72). The cost per cardiovascular event avoided was 6,625.37 euros (CI, 4821.60-8429.14 euros).