MedWire News: Results from a Chinese study show that low-dose aspirin therapy appears to convey no benefits for primary or secondary cardiovascular disease (CVD) prevention for Type 2 diabetes patients.
Indeed, use of aspirin was actually associated with an increased risk for the primary composite endpoint (a combination of death from a vascular cause and major vascular events, including hospitalizations due to nonfatal myocardial infarction [MI] and/or non-fatal stroke) in patients with no prior history of occlusive vascular disease (primary prevention).
Low-dose aspirin therapy has been shown to reduce the risk for certain types of CVD, but the benefits for diabetics, a group at high CV risk, has proved uncertain, with some studies showing no reduction in CVD risk associated with aspirin therapy, as reported by MedWire News.
In this study, Juliana Chan (The Chinese University of Hong Kong) and colleagues recruited 6454 patients with Type 2 diabetes, including 1034 with no prior CVD and 5731 with prior CVD (secondary prevention).
Overall, 18% of the primary prevention and 81% of the secondary prevention cohort were prescribed low-dose (75–325 mg/day) aspirin. The team followed-up the patients for a mean of 4.7 years.
Following adjustment for covariates, the researchers found that aspirin use in the primary prevention group increased the risk for the primary composite endpoint 2.07 fold.
In the secondary prevention group, no significant difference in CVD event rate was observed between those using aspirin and those who were not.
In the whole cohort, aspirin use increased the risk for gastrointestinal bleeding and hemorrhagic stroke 2.20 and 1.71 fold compared with nonuse.
“These results are not incompatible with the current body of knowledge based on either meta-analyses or randomized clinical trials and call for re-evaluation of the current recommendation regarding the use of aspirin in diabetic patients,” conclude Chan et al in the journal Cardiovascular Diabetology.
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No clear benefit of aspirin for primary CV prevention in diabetes