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Aspirin for cardiovascular prevention in patients with diabetes
Clinical Diabetes, 06/01/09

Ogawa H et al. – Low-dose aspirin use was associated with a non-statistically significant 20% reduction in atherosclerotic events among Japanese adults with type 2 diabetes. Further study with a larger sample size must confirm these findings.

Methods

Multicenter, randomized trial of 2,539 Japanese pts with type 2 diabetes and no history of atherosclerotic disease
Subjects age 30-85 yrs; mean age: 65 yrs; ~ 45% female
Randomization to low-dose aspirin or no aspirin in open-label design
Primary outcome: any atherosclerotic event
Atherosclerotic event defined as cardiovascular death, nonfatal myocardial infarction, unstable angina, new-onset stable angina, stroke (ischemic or hemorrhagic), transient ischemic attack, or new peripheral vascular disease
Adjudication of all outcomes by an independent committee blinded to intervention status
Median follow-up: 4.37 yrs (193 of 2,539 lost follow-up)

Results

Aspirin use was associated with a nonstatistically significant reduction in the incidence of the primary outcome: 13.6/1,000 pt-yrs for aspirin group and 17.0/1,000 pt-yrs for controls
Fewer fatal events with aspirin use; these outcomes were uncommon
Hemorrhagic stroke, gastrointestinal bleeding, and ulcers more common with aspirin group; differences not statistically significant