title: Aspirin for primary prevention of cardiovascular disease in patients with diabetes: A meta-analysis.
abstract: OBJECTIVE
  Aspirin use for primary prevention of cardiovascular disease (CVD) is controversial, especially in patients with diabetes. The objective of this meta-analysis was to evaluate aspirin's safety and efficacy for primary prevention of CVD [fatal or nonfatal myocardial infarction (MI), fatal or nonfatal stroke, angina, transient ischemic attack (TIA), peripheral artery disease (PAD) and revascularization] in patients with diabetes.
  
  
  METHODS
  A literature search was conducted using the terms cardiovascular disease, aspirin, diabetes mellitus to identify trials of patients with diabetes who received aspirin for primary prevention of CVD. Study sample size, and ischemic and bleeding events were extracted and analyzed using RevMan 5.2.7.
  
  
  RESULTS
  In total, 6 studies (n=10,117) met criteria. Aspirin doses ranged from 100mg every other day to 650mg daily. Follow-up ranged from 3.6 to 10.1years. In patients with diabetes, there was no difference between aspirin and placebo with respect to the risk of all cause mortality (OR 0.93, 95% CI 0.81-1.06), or individual atherosclerotic events compared to placebo. There were no differences in bleeding (OR 2.53, 95% CI 0.77-8.34), GI bleeding (OR 2.14, 95% CI 0.63-7.33) or hemorrhagic stroke rates (OR 0.90, 0.34-2.33) between groups.
  
  
  CONCLUSIONS
  It remains unclear whether aspirin may reduce the occurrence of a first atherosclerotic event or mortality in patients with diabetes. More research on this use of aspirin in patients with diabetes is required to supplement currently available research.
authors: United Physicians Inc., Bingham Farms, MI, United States. Electronic address: lkokoska@updoctors.com.
authors: Lianne A
authors: LA
authors: Kokoska
authors: Department of Pharmacy, Harper University Hospital, Detroit Medical Center, Detroit, MI, United States; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States. Electronic address: swilhelm@wayne.edu.
authors: Sheila M
authors: SM
authors: Wilhelm
authors: Department of Pharmacy, Harper University Hospital, Detroit Medical Center, Detroit, MI, United States; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States. Electronic address: cgarwood@wayne.edu.
authors: Candice L
authors: CL
authors: Garwood
authors: Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States; Health Centers of Detroit Medical Group, Detroit, MI, United States. Electronic address: hnberlie@wayne.edu.
authors: Helen D
authors: HD
authors: Berlie
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D048909:Diabetes Complications / Q000209:etiology / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000503:physiopathology*; D006801:Humans; D011322:Primary Prevention
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
keywords: Aspirin; Atherosclerosis; Cardiovascular disease; Diabetes mellitus; Primary prevention