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D.Caldeira1,2,3· M. Alves3,4,5 · J. J. Ferreira3,4 · F. J. Pinto1,2
Received: 5 October 2022 / Accepted: 29 December 2022 / Published online: 18 January 2023 © The Author(s) 2023
D. Caldeira
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1 Centro Cardiovascular da Universidade de Lisboa–CCUL (CCUL@RISE), Faculdade de Medicina, CEMBE, CAML, Universidade de Lisboa, Lisbon, Portugal
2 Serviço de Cardiologia, Hospital Universitário de Santa Maria–CHULN, Lisbon, Portugal
3 Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
4 Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal
5 Serviço de Medicina III, Hospital Pulido Valente, CHLN, Lisbon, Portugal
Abstract
Purpose Aspirin use among patients with diabetes in primary prevention is still a matter of debate. We aimed to evaluate the potential cardiovascular risk benefit of aspirin in primary prevention, using data from a contemporary cohort.
Methods Retrospective analysis of the VITAL cohort with>20,000 individuals at primary prevention who were followed for a median of 5.3 years. The population was evaluated according to the baseline diabetes status, and then aspirin use was evaluated among diabetic patients. Cox regression models were used to estimate the risks of mortality and cardiovascular outcomes. The estimates were reported using adjusted hazard ratio (HR) and 95% confidence intervals (95%CI).
Results Diabetic patients (n=3549; 13.7%) showed to increase the risk of all-cause mortality (HR 1.61, 95%CI 1.33–1.94), and major adverse cardiovascular events (MACE) (HR 1.36 95%CI 1.11–1.68) than non-diabetic population. Diabetic patients taking aspirin were older, more frequently man, hypertensive, current users of statins, and current smokers compared with diabetic patients who did not use aspirin at baseline. There was no difference between diabetic aspirin users and non-users regarding all-cause mortality (HR 0.80, 95%CI 0.59, 1.10), MACE (HR 0.92, 95%CI 0.64, 1.33), coronary heart disease (HR 0.98, 95%CI 0.67, 1.43), or stroke (HR 0.87, 95%CI 0.48, 1.58).
Conclusions The VITAL data confirmed diabetes as an important risk factor for cardiovascular events in a contemporary cohort but did not show cardiovascular benefits of aspirin in primary prevention among people with diabetes who were shown to be at higher risk of cardiovascular events.
Keywords Cardiovascular disease · Primary prevention · Aspirin · Diabetes
AUTHORS
Pam Chen1,2, Nalini Campillo Vilorio3 , Ketan Dhatariya4, 5, William Jeffcoate6 , Ralf Lobmann7 , Caroline McIntosh8 , Alberto Piaggesi9 , John Steinberg10, Prash Vas11, Vijay Viswanathan12, Stephanie Wu13, Fran Game14, on behalf of the International Working Group on the Diabetic Foot
INSTITUTIONS
1 Joondalup Health Campus, Ramsay Healthcare Australia, Joondalup, Western Australia, Australia
2 Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia
3 Department of Diabetology, Diabetic Foot Unit, Plaza de la Salud General Hospital, Santo Domingo, Dominican Republic
4 Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
5 Norwich Medical School, University of East Anglia, Norwich, UK
6 Retired physician, Nottingham, UK
7 Clinic for Endocrinology, Diabetology and Geriatrics, Klinikum Stuttgart, Stuttgart, Germany
8 Podiatric Medicine, School of Health Sciences, University of Galway, Ireland
9 Diabetic Foot Section, Department of Medicine, University of Pisa, Italy
10 Georgetown University School of Medicine, Washington DC, USA
11 King’s College Hospital NHS Foundation Trust, London, UK
12 MV Hospital for Diabetes and Prof M Viswanathan Diabetes Research Center, Chennai, India
13 Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
14 University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
AUTHORS
Sicco A. Bus1,2, Isabel C.N Sacco3 , Matilde Monteiro-Soares4,5,6, Anita Raspovic7 , Joanne Paton8 , Anne Rasmussen9 , Larry A. Lavery10, Jaap J. van Netten1,2, on behalf of the International Working Group on the Diabetic Foot
INSTITUTIONS
1 Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, the Netherlands
2 Amsterdam Movement Sciences, program Rehabilitation & Development, Amsterdam, the Netherlands
3 Physical Therapy, Speech and Occupational Therapy department, School of Medicine, University of São Paulo, São Paulo, Brazil
4 Higher School of Health of the Portuguese Red Cross, Lisbon, Portugal
5 Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
6 RISE@ CINTESIS, Faculty of Medicine, Oporto University, Porto, Portugal
7 Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
8 School of Health Professions, University of Plymouth, Plymouth, UK
9 Steno Diabetes Center Copenhagen, Herlev, Denmark
10 Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
Guidelines on the diagnosis and treatment of foot infection in persons with diabetes IWGDF/IDSA 2023
AUTHORS
Éric Senneville1 , Zaina Albalawi2 , Suzanne A.
van Asten3 , Zulfiqarali G. Abbas4 , Geneve Allison5 ,
Javier Aragón-Sánchez6 , John M. Embil7 , Lawrence
A. Lavery8 , Majdi Alhasan9 , Orhan Oz10, Ilker
Uçkay11, Vilma Urbančič-Rovan12, Zhang-Rong Xu13,
Edgar J.G. Peters14, on behalf of the International
Working Group on the Diabetic Foot
INSTITUTIONS
1 Department of Infectious Diseases, Gustave Dron Hospital, Tourcoing, France
2 Department of Medicine, Division of Endocrinology, Memorial University, Canada
3 Leiden University Medical Centre, Leiden, the Netherlands
4 Abbas Medical Centre, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
5 Tufts Medical Center, Department of Medicine, Boston, Massachusetts, USA
6 La Paloma Hospital, Las Palmas de Gran Canaria, Spain
7 Alberta Public Laboratories, University of Alberta Hospital, Edmonton, Alberta, Canada
8 Department of Plastic Surgery, Southwestern Medical Center, Dallas, Texas, USA
9 Department of Medicine, Prisma Health-Midlands, Columbia, South Carolina, USA
10 UT Southwestern Medical Center, Dallas, Texas, USA
11 Balgrist University Hospital, Zurich, Switzerland
12 Faculty of Medicine, University Medical Centre, University of Ljubljana, Ljubljana, Slovenia
13 Diabetes Centre, The 306th Hospital of PLA, Beijing, China
14 Department of Internal Medicine, Infection and Immunity Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
