Heart Benefits of Aspirin May Be Lacking in Diabetics
posted 12/10/03
New research reveals that, low-dose aspirin may be less effective in preventing heart disease in patients with type 2 diabetes than in other high-risk individuals.

Dr. Michele Sacco, from the Consorzio Mario Negri in Italy, and other members of the Primary Prevention Project (PPP) Collaborative Group note that low-dose aspirin reduces the risk of heart disease-related death by more than 40 percent when used by patients with at least one heart disease risk factor.

However, other research suggests that diabetics are less likely to benefit from aspirin. Therefore, the PPP group analyzed results for their study group, which included 1031 diabetics and 3753 nondiabetics followed for around 4 years. Patients were randomly selected to receive aspirin or no aspirin and vitamin E or no vitamin E.

In the diabetic group, aspirin use had little effect on the risk of death, stroke, or heart attack. However, the current study was limited in its ability to reach firm conclusions due to relatively small numbers of diabetic patients, the authors point out. Therefore, larger studies focusing specifically on diabetic patients are needed to completely assess aspirin's effects.

Until such trials are completed, at-risk diabetics and nondiabetics alike should continue using aspirin as recommended by the American Heart Association and the American Diabetes Association, Dr. John A. Colwell, from the Medical University of South Carolina in Charleston, notes in an accompanying editorial.

The benefits do clearly outweigh the risks, so long as there are no contraindications to aspirin, such as allergy or a history of GI bleeding. In fact, he believes that aspirin is underutilized as a primary preventive agent, prescribed for only about 25% of diabetics age 40 or above.

And there are other options, he added, such as GPIIb/IIIa receptor blockers or "clopidogrel, which works on platelets in a different way than aspirin." Don’t have patients stop taking their aspirin until more research is done.

Source: Diabetes In Control.com: Diabetes Care, December, 2003.

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