McMasterLogo_New-2017-300x165
Back
Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

Aspirin does not prevent cardiovascular disease (CVD) in people with diabetes who do not already have CVD

Kunutsor SK, Seidu S, Khunti K Aspirin for primary prevention of cardiovascular and all-cause mortality events in diabetes: updated meta-analysis of randomized controlled trials. Diabet Med. 2016 Apr 17. [Epub ahead of print)

Review questions

In people who have diabetes but don’t have cardiovascular disease, does aspirin prevent cardiovascular disease? Does it cause harm?

Background

Aspirin may prevent heart disease or cancer in people who have not had these diseases, but it can also cause harm (e.g., bleeding and stroke).

How the review was done

The researchers did a systematic review, searching for studies that were published up to November 2015.

They found 10 randomized controlled trials.

The trials included 16,690 people who were over 18 years of age, had diabetes, and did not have cardiovascular disease.

Aspirin was compared with placebo or no treatment for at least 1 year.

What the researchers found

Studies tested a daily dose of aspirin (75 to 650 mg).

Compared with placebo or no treatment, aspirin did not prevent major adverse cardiovascular events (that is, any of non-fatal heart attack, non-fatal stroke, or death from cardiovascular causes), heart attack, stroke, coronary heart disease, death from cardiovascular causes, or death from any cause.

Bleeding did not differ in people who received aspirin compared with those who received placebo or no treatment.

Conclusion

In people with diabetes who don’t have cardiovascular disease, aspirin does not prevent cardiovascular events or increase bleeding compared with placebo or no treatment.

Aspirin vs placebo or no treatment for prevention of cardiovascular disease in people who have diabetes

Outcomes

Number of trials (number of people)

Event rate with aspirin

Event rate with placebo or no treatment

Effect of aspirin*

Major adverse cardiovascular events†

6 trials (12,277 people)

6.3%

7.0%

No difference between groups

Heart attack

7 trials (11,618 people)

6.6%

7.9%

No difference between groups

Stroke

8 trials (11,254 people)

3.5%

4.0%

No difference between groups

Coronary heart disease

5 trials (5485 people)

5.6%

5.7%

No difference between groups

Death from cardiovascular causes

5 trials (10, 058 people)

6.6%

7.0%

No difference between groups

Death from any cause

5 trials (10, 058 people)

10%

11%

No difference between groups

Any bleeding

3 trials (7281 people)

3.1%

1.4%

No difference between groups

* Although the rates for the 2 groups look different, the differences were not statistically significant—this means that the difference could simply be due to chance rather than due to the different treatments.

†Any one of non-fatal heart attack, non-fatal stroke, or death from cardiovascular causes. The analysis includes only the trials that did not include people who had cardiovascular disease at the beginning of the study.




Glossary

Coronary heart disease
Also known as coronary artery disease (CAD), is a narrowing of the blood vessels (coronary arteries) that supply oxygen and blood to the heart.
Placebo
A harmless, inactive, and simulated treatment.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.
Vascular
The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.

Related Web Resources

  • Prediabetes: Which Treatment Should I Use to Prevent Type 2 Diabetes?

    OHRI
    This patient decision aid helps People with prediabetes considering treatment to help prevent type 2 diabetes decide on whether to make a major lifestyle change or take the medicine metformin by comparing the benefits, risks, and side effects of both options.
  • What should I eat? Types of fat

    Harvard School of Public Health
    There are three main types of fat: unsaturated, saturated and trans fat. Unsaturated fats can help improve cholesterol levels and lower inflammation and are found in olive oil, avocados, nuts, seeds and fish. Trans fats are common in fast foods, and can increase your risk of heart disease, stroke, diabetes and other chronic conditions.
  • Medication for type 2 diabetes

    Informed Health Online
    Talk to your doctor about diabetes medications. Consider your treatment goals, age, weight, health conditions and other medications when deciding if a drug is right for you.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Register