Comparison of two cardiovascular risk assessment tools to determine appropriate use of aspirin as primary prevention for patients with type 2 diabetes Jessica Porter, Pharm. D. Candidate; Lee Anna Anderson, Pharm. D. Candidate; Emily K. McCoy, Pharm. D.; Bradley M. Wright, Pharm. D., BCPS, Jessica Bellone, Pharm. D Increased Cardiovascular Risk 2010 Increased Cardiovascular Risk > 40 years of age10 year CVD risk > 10% Family history of CVD Hypertension Smoking Dyslipidemia Albuminuria Background  Diabetes increases the risk for a cardiovascular event by 2-4 times when matched by age, sex and ethnicity of non-diabetic patients  American Diabetes Association and American Heart Association recommended aspirin therapy as a primary prevention in diabetic patients with increased cardiovascular risk.  2009-ATT meta-analysis : Aspirin decreases nonfatal myocardial infarction (MI) and overall risk for vascular event  2010-Position Statement: low dose aspirin therapy is recommended as a primary prevention strategy in Type 1 or Type 2 diabetic patients with an increased cardiovascular risk Purpose The objective of this study is to determine whether there is a difference in calculated CVD risk percentages between two cardiovascular risk assessment tools. Methods  This study has been submitted to the Institutional Review Board for approval  Retrospective chart review  Inclusion Criteria:  ICD-9 code for Type 2 Diabetes  Patient of University of South Alabama Family Medicine Clinic, Stanton Road Clinic or Knollwood Physicians Group  Seen in clinic between January 1, 2011 and June 30, 2011  Exclusion Criteria:  Contraindication to antiplatelet therapy  < 30 years of age  History of GI bleed  History of cardiovascular disease, such as CHD (low grade stenosis, myocardial infarction, angina, or CABG/PCI), symptomatic carotid artery disease (transient ischemic attack or stroke), peripheral vascular disease or abdominal aortic aneurysm  Pregnant  Prisoners Patient data will be entered into both the UKPDS Risk Engine and the ARIC CHD Risk Calculator to assess the risk percentage for cardiovascular events, and the differences in the percentages calculated will be assessed. UKPDS Risk EngineARIC CHD Risk Calculator Age SBP Smoking Total cholesterol HDL Sex Ethnicity HbA1c Diabetes duration Atrial fibrillation Age SBP Smoking Total cholesterol HDL Sex Ethnicity HTN medication Diabetes Hypothesis Use of 2 risk calculators may influence the percentage used to determine CVD risk and use of aspirin as primary prevention One specific calculator may prove to be more beneficial to calculate primary prevention StrengthsLimitations Defined population based on exclusion criteria Multi-centered Calculators validated by the ADA/AHA Retrospective chart review Restricted patient population Limited ethnicity choice References Buse JB, Ginsberg HN, Bakris GL, et al. Primary Prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation. 2007; 115: American Diabetes Association. Standards of Medical Care in Diabetes Diabetes Care. 2011; 34:S11- S61. Pignone M, Alberts MJ, Colwell JA, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation. Diabetes Care. 2010;33(6): Antithrombotic Trialists’ (ATT) Collaboration. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomized trials. Lancet. 2009;373: Disclosure Authors of this presentation have nothing to disclose concerning possible financial or personal relationships with commercial entities that may have a direct or indirect interest in the subject matter of this presentation.