Cargando…
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...
Autores principales: | , , , , , , , , , , |
---|---|
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 |
_version_ | 1784738093981499392 |
---|---|
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. |
format | Online Article Text |
id | pubmed-9242621 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT parishsarah effectsofaspirinondementiaandcognitivefunctionindiabeticpatientstheascendtrial AT mafhammarion effectsofaspirinondementiaandcognitivefunctionindiabeticpatientstheascendtrial AT offeralison effectsofaspirinondementiaandcognitivefunctionindiabeticpatientstheascendtrial AT bartonjill effectsofaspirinondementiaandcognitivefunctionindiabeticpatientstheascendtrial AT wallendszuskarl effectsofaspirinondementiaandcognitivefunctionindiabeticpatientstheascendtrial AT stevenswilliam effectsofaspirinondementiaandcognitivefunctionindiabeticpatientstheascendtrial AT buckgeorgina effectsofaspirinondementiaandcognitivefunctionindiabeticpatientstheascendtrial AT haynesrichard effectsofaspirinondementiaandcognitivefunctionindiabeticpatientstheascendtrial AT collinsrory effectsofaspirinondementiaandcognitivefunctionindiabeticpatientstheascendtrial AT bowmanlouise effectsofaspirinondementiaandcognitivefunctionindiabeticpatientstheascendtrial AT armitagejane effectsofaspirinondementiaandcognitivefunctionindiabeticpatientstheascendtrial |