The effect of sarpogrelate compared to aspirin in high- or very-high-risk diabetes for primary prevention
Abstract The benefit of aspirin in primary prevention for atherosclerotic cardiovascular diseases (ASCVD) is questionable due to bleeding complications. We analyzed the Korean National Health Insurance data to compare the efficacy and overall bleeding of sarpogrelate, an antiplatelet agent with lowe...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-025-87868-x |
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| author | Soo Hyun Kang Kilyoon Pack Jung Ho Kim Youngwoo Jang |
| author_facet | Soo Hyun Kang Kilyoon Pack Jung Ho Kim Youngwoo Jang |
| author_sort | Soo Hyun Kang |
| collection | DOAJ |
| description | Abstract The benefit of aspirin in primary prevention for atherosclerotic cardiovascular diseases (ASCVD) is questionable due to bleeding complications. We analyzed the Korean National Health Insurance data to compare the efficacy and overall bleeding of sarpogrelate, an antiplatelet agent with lower bleeding risk, versus aspirin in high-/very-high-risk diabetic populations without prior ASCVD. The primary endpoint was net adverse clinical events (NACE), defined as a composite of efficacy and overall bleeding. The efficacy was a composite of all-cause death, myocardial infarction (MI) and stroke, whereas overall bleeding included intracranial hemorrhage (ICH) and gastrointestinal (GI) bleeding. A total of 10,778 high-/very-high-risk diabetic patients (9550 on aspirin, 1228 on sarpogrelate) were analyzed. After propensity score matching, sarpogrelate was linked to a lower incidence of NACE (HR:0.71; 95% CI 0.57–0.88), mainly driven by 62% reductions in overall bleeding (0.38; 0.17–0.81), a composite of 64% and 72% lower rate of GI bleeding and ICH, respectively. Additionally, there was no significant differences in MI or stroke between groups. In high- or very-high-risk diabetic patients without ASCVD, sarpogrelate use was associated with net clinical benefit mainly due to the reduction of significant reduction in overall bleeding events. |
| format | Article |
| id | doaj-art-8b30448363f14b30a092095dae29cd2f |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-8b30448363f14b30a092095dae29cd2f2025-02-02T12:24:15ZengNature PortfolioScientific Reports2045-23222025-01-0115111210.1038/s41598-025-87868-xThe effect of sarpogrelate compared to aspirin in high- or very-high-risk diabetes for primary preventionSoo Hyun Kang0Kilyoon Pack1Jung Ho Kim2Youngwoo Jang3Gachon Medical Research Institute, Gachon Biomedical Convergence Institute, Gachon University Gil Medical Center, College of Medicine, Gachon UniversityDivision of Cardiology, Gachon University Gil Medical Center, Gachon University College of MedicineGachon Medical Research Institute, Gachon Biomedical Convergence Institute, Gachon University Gil Medical Center, College of Medicine, Gachon UniversityGachon Medical Research Institute, Gachon Biomedical Convergence Institute, Gachon University Gil Medical Center, College of Medicine, Gachon UniversityAbstract The benefit of aspirin in primary prevention for atherosclerotic cardiovascular diseases (ASCVD) is questionable due to bleeding complications. We analyzed the Korean National Health Insurance data to compare the efficacy and overall bleeding of sarpogrelate, an antiplatelet agent with lower bleeding risk, versus aspirin in high-/very-high-risk diabetic populations without prior ASCVD. The primary endpoint was net adverse clinical events (NACE), defined as a composite of efficacy and overall bleeding. The efficacy was a composite of all-cause death, myocardial infarction (MI) and stroke, whereas overall bleeding included intracranial hemorrhage (ICH) and gastrointestinal (GI) bleeding. A total of 10,778 high-/very-high-risk diabetic patients (9550 on aspirin, 1228 on sarpogrelate) were analyzed. After propensity score matching, sarpogrelate was linked to a lower incidence of NACE (HR:0.71; 95% CI 0.57–0.88), mainly driven by 62% reductions in overall bleeding (0.38; 0.17–0.81), a composite of 64% and 72% lower rate of GI bleeding and ICH, respectively. Additionally, there was no significant differences in MI or stroke between groups. In high- or very-high-risk diabetic patients without ASCVD, sarpogrelate use was associated with net clinical benefit mainly due to the reduction of significant reduction in overall bleeding events.https://doi.org/10.1038/s41598-025-87868-xAspirinDiabetesBleedingPrimary preventionSarpogrelate, antiplatelet therapy |
| spellingShingle | Soo Hyun Kang Kilyoon Pack Jung Ho Kim Youngwoo Jang The effect of sarpogrelate compared to aspirin in high- or very-high-risk diabetes for primary prevention Scientific Reports Aspirin Diabetes Bleeding Primary prevention Sarpogrelate, antiplatelet therapy |
| title | The effect of sarpogrelate compared to aspirin in high- or very-high-risk diabetes for primary prevention |
| title_full | The effect of sarpogrelate compared to aspirin in high- or very-high-risk diabetes for primary prevention |
| title_fullStr | The effect of sarpogrelate compared to aspirin in high- or very-high-risk diabetes for primary prevention |
| title_full_unstemmed | The effect of sarpogrelate compared to aspirin in high- or very-high-risk diabetes for primary prevention |
| title_short | The effect of sarpogrelate compared to aspirin in high- or very-high-risk diabetes for primary prevention |
| title_sort | effect of sarpogrelate compared to aspirin in high or very high risk diabetes for primary prevention |
| topic | Aspirin Diabetes Bleeding Primary prevention Sarpogrelate, antiplatelet therapy |
| url | https://doi.org/10.1038/s41598-025-87868-x |
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