Meta-analysis: aspirin for patients with diabetes
Can aspirin be used as a primary prevention for cardiovascular events?
Aspirin is one of the most commonly used drugs in medicine. Its active ingredient is aspirin acetyl salicylic acid, which was first synthesised by Felix Hoffmann in 1897. In 1982, John Vane was awarded the Nobel prize in medicine for identifying that aspirin inhibited prostaglandin synthesis through inhibition of the enzyme cyclo-oxygenase. Prostaglandins such as thromboxane A2 promote platelet aggregation; hence aspirin is widely used in cardiovascular disease to inhibit the generation of thromboxane A2 and platelet aggregation during cardiovascular events such as acute myocardial infarction and stroke.
Aspirin is also effective when used as primary prevention treatment in populations at high risk of cardiovascular events. A recent meta-analysis of 287 trials and 135 000 participants, for example, has shown a clear effect of aspirin in reducing major cardiovascular events in such patients.1 What is not clear is whether aspirin reduces incident major cardiovascular events in healthy patients with diabetes