Does low-dose daily aspirin really reduce cardiovascular risk in diabetes?

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Takeaway

  • Recent trial data don’t solidly back guidelines encouraging use of aspirin for primary prevention of cardiovascular disease (CVD) in adults with diabetes and at increased CVD risk.

Study design

  • Systematic review and meta-analysis of randomized controlled trials of aspirin compared with placebo (or no treatment) in patients with diabetes with no history of cardiovascular disease.
  • A total of 10 randomized trials were included.

Key results

  • There was a modestly significant reduction in risk of major adverse cardiovascular events (MACE) with aspirin therapy compared with placebo or no treatment, but significance was lost with the exclusion of 1 trial that included few patients with previous CVD.
  • The effect of aspirin on major adverse cardiovascular events appeared to differ by baseline CVD risk, medication compliance, and sex (P for interaction for all .05).
  • Aspirin did not significantly reduce the overall risks of myocardial infarction (MI), coronary heart disease, stroke, ...