Cardiovascular Diabetology (Oct 2009)

Lack of benefits for prevention of cardiovascular disease with aspirin therapy in type 2 diabetic patients - a longitudinal observational study

  • Chan Francis K,
  • Ma Ronald C,
  • Kong Alice P,
  • Ko Gary T,
  • Tong Peter C,
  • Lui Augustine,
  • Stewart Derek,
  • So Wing-yee,
  • Leung Wilson Y,
  • Yang Xilin,
  • Chiang Sau-chu,
  • Chan Juliana C

DOI
https://doi.org/10.1186/1475-2840-8-57
Journal volume & issue
Vol. 8, no. 1
p. 57

Abstract

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Abstract Background The risk-benefit ratio of aspirin therapy in prevention of cardiovascular disease (CVD) remains contentious, especially in type 2 diabetes. This study examined the benefit and harm of low-dose aspirin (daily dose Methods This is a longitudinal observational study with primary and secondary prevention cohorts based on history of CVD at enrolment. We compared the occurrence of primary composite (non-fatal myocardial infarction or stroke and vascular death) and secondary endpoints (upper GI bleeding and haemorrhagic stroke) between aspirin users and non-users between January 1995 and July 2005. Results Of the 6,454 patients (mean follow-up: median [IQR]: 4.7 [4.4] years), usage of aspirin was 18% (n = 1,034) in the primary prevention cohort (n = 5731) and 81% (n = 585) in the secondary prevention cohort (n = 723). After adjustment for covariates, in the primary prevention cohort, aspirin use was associated with a hazard-ratio of 2.07 (95% CI: 1.66, 2.59, p Conclusion In Chinese type 2 diabetic patients, low dose aspirin was associated with a paradoxical increase in CVD risk in primary prevention and did not confer benefits in secondary prevention. In addition, the risk of GI bleeding in aspirin users was rather high.