Aspirin Usage in Patients With Research Paper

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In these cases, it has been mentioned that only those diabetics can benefit from the use of aspirin that have had a heart attack in the past. Thus, the usage of aspirin can help in prevention of any future heart attacks3 (p. 2365).

Analysis of Chosen studies

Study 1

The first study "Use of aspirin for primary and secondary prevention of cardiovascular disease in diabetic patients in an ambulatory care setting in Spain," has been conducted on diabetic patients. It has mentioned that diabetics are at an increased risk of cardiovascular malfunction as compared to normal population. As the title of the study indicates, the focus is on the diabetics in Spain. They study has focused on the effects of using certain drugs and medications in order to reduce or to prevent the risk of heart attacks in diabetics. The study has mentioned that the usage of salicylic acid for primary and secondary prevention has been allowed by the American Diabetes association to be used on the patients who fall in the category of primary or secondary prevention. The main aim of the study was to see the effects of recommended medications on preventive care in diabetics in Spain. The data of the study is based on the patient data spanning two years. Variables that have been included in the study are age, sex, social status, and primary care center identification. Some of the main measures that have been included in the study are use of aspirin or any other drugs, clinical parameters, rates and incidents of co-morbidities and the proportion of patients as therapeutic targets. In order to calculate levels of significance in the data collected, chi-square test, descriptive statistics, and regression was used 5.

Critique

The data has shown that the usage of aspirin is lower in Spain in the case of diabetics. It is important to see that the data added in the study points towards the lesser or no effects of aspirin on diabetics who have not yet had a heart attack. Secondly, the data also suggests that there are increased risks of usage of aspirin on diabetics based on risks of internal bleeding. An important fact that needs to be mentioned here is that the study should have suggested lesser use of aspirin in diabetics as compared to what has been suggested. On the other hand, the patient data collected by the study is of lesser variance as compared to the need and requirements of the study. The usage of aspirin is in a need to be reduced. It is important that the focus of data collection and analysis was varied and wider. The data published in the study is based on the estimates of usage of aspirin in Spain. In fact, the data should have been analyzed for the side effects of aspirin seen in diabetics in the category or primary and secondary prevention. But one of the main facts that have been mentioned in the study is that the usage of aspirin in patients of older age is higher as compared to younger patients. The data in the study has been collected covering a total of two years, but still the number of patients that have been analyzed is more than 4000, which is a strong point. One of the main facts that need to be highlighted here is that there is a need to reduce the usage of aspirin in the patients of older ages based on additional risks that are posed by aspirin. Although the fact seems to be missing in the study as it was important to be mentioned the reason and associated risks based on which aspirin is used lesser in younger people as compared to older ones.

Study 2

The second study "Low-Dose Aspirin for Primary Prevention of Atherosclerotic Events in Patients with Type 2 Diabetes." The main aim of the study was to investigate the effects of low dose aspirin in the patients with type 2 diabetes. The study has been conducted over a period of six years in japan. More than 163 medical institutions have been included in the study with more than 2600 patients. The patients have been chosen based on 5 years of follow up being diagnosed for type 2 diabetes. there are various dimensions of the study as the kind of trials that have been conducted in the study are open ended, random, end pointed, and randomized. Generally, high dosage of aspirin of 325 mg per day is recommended for high risk patients. However, as thus study focused on patients with lower risks of heart attack based on which the included trial patients were administered 80 to 100 mg of aspirin on a daily basis. Two cohorts of the patients were formed, one was administered with aspirin, and second group was the non-aspirin group. The study has concluded that there was no difference between the two groups as no risk reduction of heart attacks could be deduced in the two groups even after the administration of aspirin. The second important finding of the study was in relation to the extreme side effects of aspirin in the two groups after administration. The dosage was lower, based on which there were lesser side effects 6.

Critique

The study is an important study as the diversity of the study is much greater as compared to the first study. Statistical techniques have not been used in the study other than the use of confidence intervals. On the other hand, it can be seen that based on greater diversity of the data collected and the results obtained, the findings are more conclusive and stronger. The study has concluded that there are lesser effects of low dose aspirin on the patients with type 2 diabetes. The study has only focused on the patients included in the primary prevention. The study would have been stronger in the presence of the patients included in the secondary prevention category. Primary prevention is an important step. But more important is the secondary prevention as patients who have been diagnosed with cardiac malfunctions are the ones who need to be tested for the effects of aspirin in its low and high dosage. The study has concluded that the effects of low dosage aspirin are lesser in type 2 diabetes patients. Thereby from here, it can be added that there is a need of further studies that can show the effects of higher dosage in patients with diabetes in primary as well as secondary prevention.

Conclusion

The studies included in the paper for analysis have shown that aspirin has lesser effects on diabetic patients in the primary care. Recent secondary and tertiary literature has suggested that there is a need to change the regime of administering aspirin in low and high dosages to the patients. Firstly, there may be some reduction in the risks of cardiovascular arrest in the patients after using aspirin but the risks that are posed by aspirin are much higher and fatal as compared to the heart attack itself. Aspirin has been shown to have no effect on people younger than 65 years in reducing risks of heart attack. Secondly, even if positive effects of aspirin are seen in reducing risks of heart attacks, it has been noticed in the case of people suffering from low risk myocardial infarctions. In the case of people with serious heart complications, aspirin fails to induce any positive effects.

References

1. Chan KLF, Jessica YL, Ching MPH, Lawrence CT, Hung MD, Wong VSW, Leung KSV, Kung NN, Hui, AJ, Wu JCY, Leung KW, Lee WYV, Lee K, Lee TY, Lau WY, to FK, Chan HLY, Chung S, and Sung JJY. Clopidogrel vs. Aspirin and Esomeprazole to Prevent Recurrent Ulcer Bleeding. N Engl J. Med. 2005; 352:238-244.

2. Falk E, and Fernandez-Ortiz a. Role of thrombosis in atherosclerosis and its complications. American Journal of Cardiology. 1995: 75: 5B-11B.

3. Smith CS, Allen J, Blair JN, Bonow or, Brass LM, Fonarow, CG, Grundy, MS, Hiratzka L, Jones D, Krumholz, HM, Mosca L, Pasternak CR, Pearson T, Pfeffer MA, and Taubert KA. AHA/ACC Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2006 Update, Endorsed by the National Heart, Lung, and Blood Institute. Circulation. 2006; 113: 2363-2372.

4. Keith a. Regulating Information About Aspirin and the Prevention of Heart Attack. The American Economic Review. 1995: 85: 96-99.

5. Sicras-Mainar a, Navarro-Artieda R, Rejas-Gutierrez J, Fernandez-de-Bobadilla J, Frias-Garrido X, and Ruiz-Riera R. Use of aspirin for primary and secondary prevention of…[continue]

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