Aspirin in a diabetic retinopathy setting: Insights from NO BLIND study |
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| Institution: | 1. University of Campania “Luigi Vanvitelli”, Department of Advanced Medical and Surgical Sciences, Piazza Luigi Miraglia 2, 80138, Naples, Italy;2. University of Campania “Luigi Vanvitelli”, Department of Precision Medicine, Via de Crecchio, 7, 80138, Naples, Italy;3. “Villa Dei Fiori” Hospital, Corso Italia, 157, 80011, Acerra (Naples), Italy;4. IRCCS Fondazione G. B. Bietti, Via Livenza, 3, 00198, Rome, Italy;5. University of Molise, Department of Medicine & Health Sciences “Vincenzo Tiberio”, Via Francesco De Sanctis, 1, 86100, Campobasso, Italy;1. College of Health Sciences Vin University Hanoi, Viet Nam;2. Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Italy;3. Department of Preventive Medical Science, University of Naples Federico II, Italy;1. Department of Laboratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University & Yuying Children''s Hospital, Wenzhou, China;2. NAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;3. Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;4. Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;5. Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;6. Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy;7. Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton General Hospital, Southampton, UK;8. Institute of Hepatology, Wenzhou Medical University, Wenzhou, China;9. The Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China;1. Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea;2. Department of Information & Statistics, Chungbuk National University, Cheongju, Republic of Korea;3. Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Chungbuk, Republic of Korea;1. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China;2. Research Center for Coronary Heart Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China;1. Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;2. School of Public Health, Xi''an Jiaotong University, Xi''an, China;3. Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China;4. Department of Epidemiology, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;5. Peking University Clinical Research Institute, Beijing, China;1. Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, China;2. Department of Rheumatology, Changhai Hospital, Naval Military Medical University (The Second Military Medical University), Shanghai, China;3. Department of Endocrinology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, China;4. Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, China;5. Department of Endocriology, Punan Hospital of Pudong New District, Shanghai, China;6. Department of Traffic Management Engineering, Zhejiang Police College, Hangzhou, China |
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| Abstract: | Background and aimsDiabetic retinopathy (DR) is the most common microvascular complication of diabetes. Diabetic macroangiopathies, particularly cardiovascular (CV) diseases, seem closely related to diabetes microvascular complications. Aspirin represents the most prescribed compound in CV prevention. Aspirin impact on DR is still object of debate. As it is already recommended among diabetics at high CV risk, aim of this study was to assess a potential relationship between DR and aspirin therapy, in a type 2 diabetes cohort of patients screened through telemedicine.Methods and resultsNO Blind is a cross-sectional, multicenter, observational study, which involved nine Italian outpatient clinics. Primary endpoint was the assessment of the relationship between aspirin treatment and DR. 2068 patients were enrolled in the study, subsequently split in two subpopulations according to either the presence or absence of DR. Overall, 995 subjects were under aspirin therapy. After adjusting for most common potential confounders, age and gender, aspirin reveals significantly associated with DR (OR: 1.72, 95%CI: 1.58–2.89, p = 0.002) and proliferative DR (PDR) (OR: 1.89, 95%CI: 1.24–2.84, p = 0.003). Association comes lost further adjusting for MACEs (OR: 1.28, 95%CI: 0.85–1.42, p = 0.157) (Model 4) and eGFR (OR: 0.93; 95%CI: 0.71–1.22; p = 0.591) (Model 5).ConclusionIn this multicenter cross-sectional study including a large sample of outpatients with T2DM, we showed that aspirin was not associated with DR after adjustment for several cardio-metabolic confounders. However, as partially confirmed by our findings, and related to the well-known pro-hemorrhagic effect of aspirin, its use should be individually tailored, even by telemedicine tools. |
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| Keywords: | Diabetic retinopathy Aspirin Type 2 diabetes Diabetes complications |
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