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Type 2 Diabetics Studied in Low-Dose Aspirin Trial
Date:11/11/2008

herosclerotic events include coronary heart disease death, fatal stroke, non-fatal myocardial infarction, unstable angina, exertional angina, non-fatal stroke including transient ischemic attack, and peripheral arterial disease.

In a subgroup analysis, the researchers found an association between daily low-dose aspirin use and a 32 percent reduced relative risk for all atherosclerotic events, both fatal and non-fatal, but only for diabetics over age 65. In other words, individuals over age 65 who took aspirin had a hazard ratio of 0.68 compared to those who did not take aspirin.

During an average of 4.4 years of follow-up, 154 atherosclerotic events occurred, both fatal and non-fatal (68 in the aspirin group, 86 in the non-aspirin group.) Those events included one fatal cardiovascular event (a hemorrhagic stroke) in the aspirin group and 10 fatal strokes or heart attacks in the non-aspirin group, Ogawa said.

Researchers found a large, statistically significant risk reduction for fatal coronary and cerebrovascular events in the aspirin group vs. the non-aspirin group (hazard ratio of 0.10.) But the confidence interval on that finding was wide (CI=0.01 to 0.8), indicating a need for further study, he said.

Diabetes is considered one of the strongest risk factors for cardiovascular events. Aspirin therapy is commonly used for primary prevention in diabetic patients in the United States and Canada, but not in Japan, Ogawa said.

Several earlier studies have established the benefits of aspirin therapy in preventing second cardiac events. However, its use for primary prevention in diabetics, i.e., prevention in patients without a history of cardiovascular disease, has been controversial because of the lack of data indicating benefits and because aspirin carries a risk of gastric bleeding, Ogawa said.

He said aspirin was well tolerated as demonstrated by the comparable number of the combined endpoint of serious hemorrhagic events (h
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SOURCE American Heart Association
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