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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

* 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.