Antiplatelet Therapy as a Primary Prevention Strategy for Cardiovascular Disease in Type 2 Diabetes Mellitus in Taiwan—A Population-Based Study

Abstract

Purpose: The American diabetes association (ADA) standards of medical care in diabetes 2017 recommends considering aspirin therapy as a primary prevention strategy for patients with type 2 diabetes who are at increased cardiovascular risk. The aim of this study was to investigate the prescription rate of antiplatelet as a primary prevention treatment in diabetes patients in Taiwan. Methods: We conducted a new user cohort from the Taiwan longitudinal cohort of diabetes patients (LCDP) between 1999 and 2013 in diabetes patients aged over 20. We stratified these patients into three risk group (low, intermediate, and high risk) according to the standards of medical care in diabetes 2017 to explore the utilization of antiplatelet agent as a primary prevention strategy in each risk stratification. Results: We assembled a diabetic cohort (n=513,012) who were potentially eligible for primary prevention therapy. We then stratified them into low (n= 27,572), intermediate (n=190,038) and high (n= 295,402) cardiovascular risk. Around 1% of patients in the low-risk group were dispensed antiplatelet agents, 8% in the intermediate-risk group, and about 16% in the high-risk groups. The median dispensing days for total follow-up period in those with low risk was 189 days, equally 12% of the period from initiating antiplatelet agents to study end. The median dispensing days for those with high risk was 392 days, about one-fourth of the period from starting antiplatelet agents to study end. Conclusions: Aspirin or alternative effective antiplatelet agents as a primary prevention treatment for type 2 diabetes patients with increased cardiovascular risks were underutilized in Taiwan. Disclosure Y. Yeh: None. P. Chen: None. Y. Chen: None.