If you haven't seen the news about this study, you soon will. I have received many questions from my diabetic patients after they read this: should I be taking an aspirin a day or not? A new study says if you are diabetic but do not have heart disease aspirin might not help you out. Here is the story. 

A recent trial concluded that aspirin and antioxidants offer no primary benefit in reducing cardiovascular events in diabetics. The study was a multi-center, randomized, placebo-controlled trial to find whether aspirin and antioxidant therapy, combined or alone, reduced the cardiovascular events in type 1 and 2 diabetics with asymptomatic peripheral arterial disease. This means they took Diabetics with NO KNOWN heart disease but some evidence (based on ultrasound studies of the vessels in their lower legs) of peripheral vascular disease and asked the question: will aspirin reduce the risk of these people developing heart attack or stroke?

How was the study done: 1,276 diabetic adults aged 40 or over with no symptomatic heart disease were given either daily 100 mg of aspirin and antioxidant; aspirin and placebo; placebo and antioxidant; or placebo alone. They looked to see if these interventions reduced either: death from coronary heart disease or stroke, non-fatal heart attack or strokes, or amputation above the ankle.

What did they find? Overall, 18.2% of those in the aspirin group had an "event" (heart attack, stroke or amputation) compared with 18.3% in the non-aspirin group.  In the aspirin group, 6.7% of deaths occurred from coronary heart disease or stroke compared with 5.5% in the non-aspirin groups.  There was also no difference in the antioxidant vs. the non-antioxidant groups

What is the take home message?  First, it is one study....but it was a good one. Second, this study is important because the researchers found no evidence to support the use of either aspirin or antioxidants in the primary prevention of cardiovascular events and mortality in diabetics. Primary prevention means if you give 100 mg of aspirin daily to type I or II diabetics with NO KNOWN heart disease you may not be doing anything to prevent heart disease or stroke. However, we all should remember that aspirin is effective as prevention when given to diabetics for secondary prevention of cardiovascular disease, meaning those with KNOWN heart disease.

Thoughts?

Dr O.