Prevalence of antiplatelet use for primary prevention of cardiovascular diseases and its' justification among an urban Sri Lankan cohort of patients with cardiovascular risk factors

Abstract

BACKGROUND: Guidelines on aspirin for primary prevention of cardiovascular diseases (CVD) has changed. There are no data on aspirin use for primary prevention from Sri Lanka or South Asia. OBJECTIVES: We aimed to describe antiplatelet use in primary prevention and its' justification in relation to latest guidelines in a cohort of patients with CV risk factors attending a follow-up medical clinic since 2007 of a community surveys of urban Sri Lanka. METHODS: A descriptive study was conducted of all patients with CV risk factors but without previous CVDs attending the above clinic from March 2018 -March 2019. Data were collected using an interviewer administered questionnaire. Patients' 10-year CV risk was calculated with WHO charts (SEAR B). Data were analyzed using SPSS-version 22. RESULTS: 170(137(80.6%) female, mean age 66.0± (6.70) years) were studied. Prevalence of CV risk factors; diabetes-mellitus, hypertension, hyperlipidemia and smoking were 80(47.1%), 114(67.5%), 150(89.3. %), 4(2.4%) respectively. 24(14.1%) were on antiplatelet for primary prevention. All were on aspirin. Aspirin prescription was justifiable in 4(25.0%) who were 50-69 years and had a 10-year CV risk of more than 10% according to US preventive task force recommendations. However, 7(16.3%) patients aged 70-years or more were on antiplatelet without justification. None of the patients have had serious adverse effects with aspirin. However, 50% had symptoms of gastritis. CONCLUSIONS: Even though antiplatelet use for primary prevention is not common in this cohort of urban Sri Lankans, a significant proportion of elderly were on antiplatelet without justification. Further, half of the patients experienced symptoms related to antiplatelet related side effects.