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Evidence Summary
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Got It, Hide thisAspirin does not prevent cardiovascular disease (CVD) in people with diabetes who do not already have CVD
Kunutsor SK, Seidu S, Khunti K Aspirin for primary prevention of cardiovascular and all-cause mortality events in diabetes: updated meta-analysis of randomized controlled trials. Diabet Med. 2016 Apr 17. [Epub ahead of print)
Review questions
In people who have diabetes but don’t have cardiovascular disease, does aspirin prevent cardiovascular disease? Does it cause harm?
Background
Aspirin may prevent heart disease or cancer in people who have not had these diseases, but it can also cause harm (e.g., bleeding and stroke).
How the review was done
The researchers did a systematic review, searching for studies that were published up to November 2015.
They found 10 randomized controlled trials.
The trials included 16,690 people who were over 18 years of age, had diabetes, and did not have cardiovascular disease.
Aspirin was compared with placebo or no treatment for at least 1 year.
What the researchers found
Studies tested a daily dose of aspirin (75 to 650 mg).
Compared with placebo or no treatment, aspirin did not prevent major adverse cardiovascular events (that is, any of non-fatal heart attack, non-fatal stroke, or death from cardiovascular causes), heart attack, stroke, coronary heart disease, death from cardiovascular causes, or death from any cause.
Bleeding did not differ in people who received aspirin compared with those who received placebo or no treatment.
Conclusion
In people with diabetes who don’t have cardiovascular disease, aspirin does not prevent cardiovascular events or increase bleeding compared with placebo or no treatment.
Aspirin vs placebo or no treatment for prevention of cardiovascular disease in people who have diabetes
| Outcomes | Number of trials (number of people) | Event rate with aspirin | Event rate with placebo or no treatment | Effect of aspirin* |
| Major adverse cardiovascular events† | 6 trials (12,277 people) | 6.3% | 7.0% | No difference between groups |
| Heart attack | 7 trials (11,618 people) | 6.6% | 7.9% | No difference between groups |
| Stroke | 8 trials (11,254 people) | 3.5% | 4.0% | No difference between groups |
| Coronary heart disease | 5 trials (5485 people) | 5.6% | 5.7% | No difference between groups |
| Death from cardiovascular causes | 5 trials (10, 058 people) | 6.6% | 7.0% | No difference between groups |
| Death from any cause | 5 trials (10, 058 people) | 10% | 11% | No difference between groups |
| Any bleeding | 3 trials (7281 people) | 3.1% | 1.4% | No difference between groups |
Glossary
Also known as coronary artery disease (CAD), is a narrowing of the blood vessels (coronary arteries) that supply oxygen and blood to the heart.
A harmless, inactive, and simulated treatment.
Studies where people are assigned to one of the treatments purely by chance.
A comprehensive evaluation of the available research evidence on a particular topic.
The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.
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