Does aspirin prevent cardiovascular events in people with diabetes?
From: Diabetes Care
- Pignone, M., Alberts, M.J., Colwell, J.A., Cushman, M., Inzucchi, S.E., Mukherjee, D., Rosenson, R.S., Williams, C.D., Wilson, P.W., Kirkman, M.S., 2010. 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. Dia Care 33, 1395–1402.
- N/A - The paper is a policy statement
- The study represents “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”.
- Aspirin appears to produce a modest-sized reduction in heart attcks and stroke in patients with diabetes, but current evidence is not conclusive because there have been too few events in the available trials to precisely estimate its effects
- The main adverse effects appear to be an increased risk of gastrointestinal bleeding.
- The average daily dose used in the trials involving participants with diabetes ranged from 50 to 650 mg daily. Although no definitive dose has been established evidence from the one of the trials suggests that the risk reductions achieved with low doses (75–162 mg/day) are as large as those obtained with higher doses (500 – 1,500 mg/day).
- Low-dose (75–162 mg/day) aspirin use for prevention is reasonable for adults with diabetes and no previous history of vascular disease who are at increased cardiovascular disease risk and who are not at increased risk for bleeding (based on a history of previous gastrointestinal bleeding or peptic ulcer disease or concurrent use of other medications that increase bleeding risk, such as NSAIDS or warfarin).
- Aspirin should not be recommended for CVD prevention for adults with diabetes at low CVD risk (men under age 50 years and women under 60 years with no major additional CVD risk factors) as the potential adverse effects from bleeding offset the potential benefits.
- Low-dose (75–162 mg/day) aspirin use for prevention might be considered for those with diabetes at intermediate CVD risk (younger patients with one or more risk factors, or older patients with no risk factors).
- Yes (without confidence)