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IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Reviews in cardiovascular medicine Pub Date : 2025-01-20 eCollection Date: 2025-01-01 DOI:10.31083/RCM26009

Fan Zhang, Hongyan Zheng

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引用次数: 0

摘要

背景：阿司匹林治疗被推荐为2型糖尿病（T2DM）患者心血管疾病（CVD）的二级预防策略，也可作为潜在的一级预防策略。然而，阿司匹林耐药性在糖尿病患者中十分常见，从而影响了阿司匹林治疗的效果。因此，我们的研究试图评估 T2DM 患者阿司匹林耐药性（AR）的临床预测因素：我们对三个主要医学数据库（PubMed、Embase 和 Cochrane Library）进行了系统检索，以确定截至 2024 年 9 月 17 日的相关文章。从所选研究中提取了出版物和调查参数的详细信息。我们利用 R 语言软件中的 meta 软件包来综合有关 AR 临床预测因素的证据。根据所纳入研究的异质性，我们采用了固定效应或随机效应模型。汇总结果采用森林图直观显示：我们的研究最终共纳入了 10 篇文献（n = 2113 名患者）。AR主要与特定的实验室参数有关，尤其是那些表明胰岛素抵抗和血脂管理不足的参数。具体来说，与 AR 相关的实验室参数包括空腹血糖水平（平均差 (MD) = 8.21；95% 置信区间 (CI) = 2.55 至 13.88）、糖化血红蛋白（MD = 0.22；95% CI = 0.06 至 0.38）、高密度脂蛋白 (HDL) 水平（MD = -2.02; 95% CI = -3.62 to -0.42）、低密度脂蛋白（LDL）水平（MD = 7.00; 95% CI = 2.87 to 11.13）、总胆固醇水平（MD = 9.52; 95% CI = 4.37 to 14.67）和甘油三酯水平（MD = 12.51; 95% CI = 3.47 to 21.55）：与血脂异常和血糖水平相关的指标是 T2DM 患者 AR 的可靠指标。这些研究结果表明，评估血脂和血糖调节可促进针对糖尿病相关血管并发症的个性化预防方法的发展：CRD42023388170，https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=388170。

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Clinical Predictors of Aspirin Resistance in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Background: Aspirin treatment is recommended as a secondary prevention strategy and could be a potential primary prevention strategy for cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM). However, aspirin resistance is notably common among diabetic patients, compromising the efficacy of aspirin treatment. Hence, our study sought to assess the clinical predictors of aspirin resistance (AR) in T2DM patients.

Methods: We conducted a systematic search of three major medical databases (PubMed, Embase, and Cochrane Library) to identify relevant articles up to September 17, 2024. Details of publications and investigated parameters were extracted from the selected studies. The meta package in the R language software was utilized to synthesize the evidence concerning clinical predictors of AR. We applied either a fixed- or random effects model based on the heterogeneity observed among the included studies. The pooled results were visually displayed using forest plots.

Results: In total, 10 publications were finally included in our study (n = 2113 patients). AR was predominantly linked to specific laboratory parameters, particularly those indicative of heightened insulin resistance and inadequate lipid management. Specifically, the laboratory parameters associated with AR included fasting glucose level (mean difference (MD) = 8.21; 95% confidence interval (CI) = 2.55 to 13.88), glycated hemoglobin (MD = 0.22; 95% CI = 0.06 to 0.38), high-density lipoprotein (HDL) level (MD = -2.02; 95% CI = -3.62 to -0.42), low-density lipoprotein (LDL) level (MD = 7.00; 95% CI = 2.87 to 11.13), total cholesterol level (MD = 9.52; 95% CI = 4.37 to 14.67), and triglyceride levels (MD = 12.51; 95% CI = 3.47 to 21.55).

Conclusions: Markers associated with dyslipidemia and blood glucose levels are robust indicators of AR in individuals with T2DM. These findings imply that assessing lipid and glucose regulation could enhance the development of personalized preventive approaches for vascular complications linked to diabetes.

The prospero registration: CRD42023388170, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=388170.

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来源期刊

Reviews in cardiovascular medicine 医学-心血管系统

CiteScore

2.70

自引率

3.70%

发文量

377

审稿时长

1 months

期刊介绍： RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.