Key messages from scientific research that's ready to be acted on
Got It, Hide thisKunutsor 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)
In people who have diabetes but don’t have cardiovascular disease, does aspirin prevent cardiovascular disease? Does it cause harm?
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).
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.
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.
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.
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 |