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Aspirin Associated with Reduced Cardiovascular and All-Cause Mortality in Type 2 Diabetes

Posted: Sunday, February 07, 2010

Regular low-dose aspirin may reduce all-cause and CVD mortality in a primary prevention setting in Type 2 diabetes.

This objective of this study was to determine whether regular aspirin use (¡Ý75 mg/day) is independently associated with cardiovascular disease (CVD) and all-cause mortality in community-based patients with Type 2 diabetes and no history of CVD.

Of the Type 2 diabetic patients recruited to the longitudinal observational Fremantle Diabetes Study, 651 (50.3%) with no prior CVD history at entry between 1993 and 1996 were followed until death or the end of June 2007, representing a total of 7,537 patient-years (mean ¡À SD 11.6 ¡À 2.9 years). Cox proportional hazards modeling was used to determine independent baseline predictors of CVD and all-cause mortality including regular aspirin use.

There were 160 deaths (24.6%) during follow-up, with 70 (43.8%) due to CVD. In Kaplan-Meier survival analysis, there was no difference in either CVD or all-cause mortality in aspirin users versus nonusers (P = 0.52 and 0.94, respectively, by log-rank test). After adjustment for significant variables in the most parsimonious Cox models, regular aspirin use at baseline independently predicted reduced CVD and all-cause mortality (hazard ratio [HR] 0.30 [95% CI 0.09¨C0.95] and 0.53 [0.28¨C0.98[, respectively; P ¡Ü 0.044). In subgroup analyses, aspirin use was independently associated with reduced all-cause mortality in those aged ¡Ý65 years and men.

From the results it was concluded that regular low-dose aspirin may reduce all-cause and CVD mortality in a primary prevention setting in Type 2 diabetes. All-cause mortality reductions are greatest in men and in those aged ¡Ý65 years. The present observational data support recommendations that aspirin should be used in primary CVD prevention in all but the lowest risk patients.

Source: Diabetes In Control: Diabetes Care, February 2010, vol. 33 no. 2 317-321