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Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial

AIMS: Aspirin is widely used in cardiovascular disease prevention but is also associated with an increased risk of bleeding. The net effect of aspirin on dementia and cognitive impairment is uncertain. METHODS AND RESULTS: In the ASCEND trial, 15 480 people from the UK with diabetes and no history o...

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Autores principales: Parish, Sarah, Mafham, Marion, Offer, Alison, Barton, Jill, Wallendszus, Karl, Stevens, William, Buck, Georgina, Haynes, Richard, Collins, Rory, Bowman, Louise, Armitage, Jane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242621/
https://www.ncbi.nlm.nih.gov/pubmed/35393614
http://dx.doi.org/10.1093/eurheartj/ehac179
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author Parish, Sarah
Mafham, Marion
Offer, Alison
Barton, Jill
Wallendszus, Karl
Stevens, William
Buck, Georgina
Haynes, Richard
Collins, Rory
Bowman, Louise
Armitage, Jane
author_facet Parish, Sarah
Mafham, Marion
Offer, Alison
Barton, Jill
Wallendszus, Karl
Stevens, William
Buck, Georgina
Haynes, Richard
Collins, Rory
Bowman, Louise
Armitage, Jane
author_sort Parish, Sarah
collection PubMed
description AIMS: Aspirin is widely used in cardiovascular disease prevention but is also associated with an increased risk of bleeding. The net effect of aspirin on dementia and cognitive impairment is uncertain. METHODS AND RESULTS: In the ASCEND trial, 15 480 people from the UK with diabetes and no history of cardiovascular disease were randomized to aspirin 100 mg daily or matching placebo for a mean of 7.4 years. The 15 427 ASCEND participants with no recorded dementia prior to baseline were included in this cognitive study with a primary pre-specified outcome of ‘broad dementia’, comprising dementia, cognitive impairment, or confusion. This was ascertained through participant, carer, or general practitioner report or hospital admission diagnosis, by 31 March 2019 (∼2 years beyond the scheduled treatment period). The broad dementia outcome occurred in a similar percentage of participants in the aspirin group and placebo group: 548 participants (7.1%) vs. 598 (7.8%), rate ratio 0.91 [95% confidence interval (CI), 0.81–1.02]. Thus, the CI excluded proportional hazards of >2% and proportional benefits of >19%. CONCLUSION: Aspirin does not have a large proportional effect on the risk of dementia. Trials or meta-analyses with larger total numbers of incident dementia cases to increase statistical power are needed to assess whether any modest proportional 10–15% benefits of 5–7 years of aspirin use on dementia exist. CLINICAL TRIAL REGISTRATION: Current Controlled Trials number, ISRCTN60635500; ClinicalTrials.gov number: NCT00135226.
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spelling pubmed-92426212022-06-30 Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial Parish, Sarah Mafham, Marion Offer, Alison Barton, Jill Wallendszus, Karl Stevens, William Buck, Georgina Haynes, Richard Collins, Rory Bowman, Louise Armitage, Jane Eur Heart J Fast Track Clinical Research AIMS: Aspirin is widely used in cardiovascular disease prevention but is also associated with an increased risk of bleeding. The net effect of aspirin on dementia and cognitive impairment is uncertain. METHODS AND RESULTS: In the ASCEND trial, 15 480 people from the UK with diabetes and no history of cardiovascular disease were randomized to aspirin 100 mg daily or matching placebo for a mean of 7.4 years. The 15 427 ASCEND participants with no recorded dementia prior to baseline were included in this cognitive study with a primary pre-specified outcome of ‘broad dementia’, comprising dementia, cognitive impairment, or confusion. This was ascertained through participant, carer, or general practitioner report or hospital admission diagnosis, by 31 March 2019 (∼2 years beyond the scheduled treatment period). The broad dementia outcome occurred in a similar percentage of participants in the aspirin group and placebo group: 548 participants (7.1%) vs. 598 (7.8%), rate ratio 0.91 [95% confidence interval (CI), 0.81–1.02]. Thus, the CI excluded proportional hazards of >2% and proportional benefits of >19%. CONCLUSION: Aspirin does not have a large proportional effect on the risk of dementia. Trials or meta-analyses with larger total numbers of incident dementia cases to increase statistical power are needed to assess whether any modest proportional 10–15% benefits of 5–7 years of aspirin use on dementia exist. CLINICAL TRIAL REGISTRATION: Current Controlled Trials number, ISRCTN60635500; ClinicalTrials.gov number: NCT00135226. Oxford University Press 2022-04-08 /pmc/articles/PMC9242621/ /pubmed/35393614 http://dx.doi.org/10.1093/eurheartj/ehac179 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Fast Track Clinical Research
Parish, Sarah
Mafham, Marion
Offer, Alison
Barton, Jill
Wallendszus, Karl
Stevens, William
Buck, Georgina
Haynes, Richard
Collins, Rory
Bowman, Louise
Armitage, Jane
Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial
title Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial
title_full Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial
title_fullStr Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial
title_full_unstemmed Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial
title_short Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial
title_sort effects of aspirin on dementia and cognitive function in diabetic patients: the ascend trial
topic Fast Track Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242621/
https://www.ncbi.nlm.nih.gov/pubmed/35393614
http://dx.doi.org/10.1093/eurheartj/ehac179
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