Aspirin or dipyridamole use reduces risk of retinopathy in diabetics: study

Researchers investigated whether antiplatelet/anticoagulant (APAC) therapy can protect patients with type 2 diabetes mellitus (T2DM) from the development or progression of diabetic retinopathy (DR). This is a retrospective cohort study using Longitudinal Health Insurance Database in Taiwan. A total of 73,964 type 2 diabetic patients older than 20 years old were included. Hazard ration (HR) of non-proliferative DR (NPDR), proliferative DR (PDR), and diabetic macular oedema (DME) were analyzed with APAC usage as a time-dependent covariate. Age, sex, comorbidities, and medicines were further adjusted in a multi-variable model. Contributions of respective antiplatelet/anticoagulant (APAC) were investigated with sensitivity analysis.

The results of the study are:

• Compared with nonusers, antiplatelet/anticoagulant (APAC) users had a lower cumulative incidence of NPDR (P < 0.001), overall incidence of non-proliferative DR (NPDR) (10.7 per 1000 person-years), and risk of developing NPDR (adjusted HR = 0.78, 95% CI = 0.73–0.83).
  
• However, no significant differences were observed between antiplatelet/anticoagulant (APAC) users and nonusers in the risks of PDR or DME. Hypertension, diabetic nephropathy and diabetic neuropathy were risk factors for NDPR development, while heart disease, cardiovascular disease, peripheral arterial occlusive disease, and statin usage were covariates decreasing non-proliferative DR (NPDR) development.
  
• Aspirin and Dipyridamole showed significant protection against non-proliferative DR (NPDR) development.
  
• Clopidogrel, Ticlopidine, and warfarin showed enhanced protection in combination with aspirin usage.

Thus, antiplatelet/anticoagulant (APAC) medications have a protective effect against NPDR development. Diabetic patients benefit from single-use of aspirin or dipyridamole for the prevention of non-proliferative DR (NPDR).

Reference:

Effect of anticoagulant/antiplatelet therapy on the development and progression of diabetic retinopathy by Chi-Juei Jeng, et al. published in the BMC Ophthalmology.

https://doi.org/10.1186/s12886-022-02323-z

Keywords:

The effect, anticoagulant, antiplatelet therapy, development, progression, diabetic retinopathy, type 2 diabetes, Chi-Juei Jeng, BMC Ophthalmology, non-proliferative diabetic retinopathy, aspirin, dipyridamole therapy, Chi-Juei Jeng, Yi-Ting Hsieh, Cheng-Li Lin & I-Jong Wang