ASCEND trial from UK has found no benefit of aspirin preventing heart attacks or stroke in their 7.4 years long placebo-control trials?
what is your say?
As long as stroke and heart attack occurs because of blood clotting, aspirin helps increase the blood liquidity and mitigation of the occurrence of these diseases.
CVD is the leading cause of morbidity and mortality for patients with diabetes. The benefit of aspirin used for CVD primary prevention is controversial. Meta-analyses report aspirin does not prevent CVD endpoints nor increase bleeding.
Aspirin for primary prevention of cardiovascular disease in patients ...
https://www.sciencedirect.com/science/article/pii/S0168822716302674
I think these link and PDF also would be useful
Please Check
1) Kokoska L, Wilhelm S, Garwood C, & Berlie H. (2016). Aspirin for primary prevention of cardiovascular disease in patients with diabetes: A meta-analysis. Diabetes Research & Clinical Practice, 120, 31-39.
2) Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomised controlled trials - January 19, 2010
3) Casado-Arroyo R. Aspirin and diabetes mellitus in primary prevention: the Endless Conundrum. Ann Transl Med. 2018;6(11):218.
4) Jennifer G. Foster, Sarah K. Wood, Marc A. Pfeffer, David L. DeMets, Alan Garber, and Charles H.
5) Hennekens (2018) ASPIRIN FOR PRIMARY PREVENTION IN PATIENTS WITH TYPE 2 DIABETES. Endocrine Practice: October 2018, Vol. 24, No. 10, pp. 925-927.
6) Pignone M, Alberts MJ, Colwell JA, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation. Diabetes Care. 2010;33(6):1395-402.
Dear sir
The use of Aspirin among patients with diabetes depends on cardiovascular risk assessment and age, those who are 50 years or old are recommended for Aspirin. The situation for patients less than 40 years with cardiovascular risk is to weigh the risks and benefits.
yes i guess its had=s to trickle down to personalized medicine....can't have a blanket statement here
Hi Sikandar,, very good question. Recently three trials have shown no benifit of aspirin in primary prevention of cardiovascular outcome including diabetic patient. Benifits of aspirin is lost because of increased incidence of bleeding mainly GT tract bleeding. If upper GI bleeding can be prevented by judicious use of proton pump inhibitor, then outcome could have be an different. In my opinion use of clopidogrel in place of aspirin might show outcome benifit in these patients. However some large trial is required.. Thanks
Diabetic patient especially the elderly one associated with increase risk of CVD like angina, heart failure, hypertension and so on, So use of aspirin (antiplatelet) will reduce incidence these complications.
I have been following the discussions and have to agree with Andrei's conclusion. We have to be very clear in differentiating the benefit of aspirin in secondary prevention from the lack of benefit in primary prevention demonstrated conclusively from the ASCEND study (and previous metaanalysis).
The philosophical question is whether the practise of medicine is a SCIENCE or an ART. The scientific evidence is now quite definitive (based on population based evidence) but one has to treat the individual patient sitting across your desk and translate the "population based" evidence to the individual patient, without deviating too much from the evidence. That is the ART of Personalised medicine. Another philosophical area I have always taken into consideration (and it is the patient's choice!!) is the following: Isn't the clinical sequel and residual disability (including quality of life) worse following a cerebral bleed (side effect of aspirin) than recovering after a coronary event (which MAY result from denying the patient aspirin therapy). Food for thought!!
Please check
1. Pignone M, Alberts MJ, Colwell JA, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation. Diabetes Care. 2010;33(6):1395-402.
2. Jennifer G. Foster, Sarah K. Wood, Marc A. Pfeffer, David L. DeMets, Alan Garber, and Charles H. Hennekens (2018) ASPIRIN FOR PRIMARY PREVENTION IN PATIENTS WITH TYPE 2 DIABETES. Endocrine Practice: October 2018, Vol. 24, No. 10, pp. 925-927.
3. Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomised controlled trials - January 19, 2010
4. Jonathan D. Newman, Arthur Z. Schwartzbard, Howard S. Weintraub, Ira J.Goldberg, Jeffrey S. Berger. Primary Prevention of Cardiovascular Disease in Diabetes Mellitus.Journal of the American College of Cardiology Aug 2017, 70 (7) 883-893; DOI: 10.1016/j.jacc.2017.07.001
Great @Entedhar Sarhat
Very evidence based reply. I think i must dedicate the coming weekend to these articles/position statements.
Thanks a lot
Aspirin is used as a form of prevention and treatment for many heart diseases including coronary sclerosis, thrombosis of the peripheral arteries after birth, pulmonary embolism and stroke. "
Dear, aspirin prevents coagulation process thereby reducing thrombus formation and control of cardiovascular diseases.
Dear Emmanuel Ifeanyi Obeagu
Thanks for your comments.
But what about use as a primary prevention drug. Yes it has a definite role in secondary prevention in various atherosclerotic cardiovascular disease(ASCVD)
Regards
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