2019
DOI: 10.1186/s12933-019-0875-4
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Abstract: Background The clinical benefit of aspirin for the primary prevention of cardiovascular disease (CVD) in diabetes remains uncertain. To evaluate the efficacy and safety of aspirin for the primary prevention of cardiovascular outcomes and all-cause mortality events in people with diabetes, we conducted an updated meta-analysis of published randomised controlled trials (RCTs) and a pooled analysis of individual participant data (IPD) from three trials. Methods Randomised … Show more

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Cited by 47 publications
(32 citation statements)
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“…There is no current clear strategy of antiplatelet therapy for primary prevention in those with T2DM. For example, whilst some evidence suggests that aspirin therapy targeted by assessment of cardiovascular and bleeding risk may be of benefit [40], guidelines remain conflicted on the extent to which, if at all, aspirin therapy should be recommended in this situation [41,42]. P2Y 12 inhibitors are alternative antiplatelet agents to aspirin with the potential benefits of prolonged presence in the plasma that might overcome reduced aspirin effect due to high platelet turnover and avoiding gastric erosion [43].…”
Section: Discussionmentioning
confidence: 99%
“…There is no current clear strategy of antiplatelet therapy for primary prevention in those with T2DM. For example, whilst some evidence suggests that aspirin therapy targeted by assessment of cardiovascular and bleeding risk may be of benefit [40], guidelines remain conflicted on the extent to which, if at all, aspirin therapy should be recommended in this situation [41,42]. P2Y 12 inhibitors are alternative antiplatelet agents to aspirin with the potential benefits of prolonged presence in the plasma that might overcome reduced aspirin effect due to high platelet turnover and avoiding gastric erosion [43].…”
Section: Discussionmentioning
confidence: 99%
“…However, while high doses of aspirin (≥ 1,000 mg per day) inhibits the COX-2 isozyme more strongly than COX-1; low doses of aspirin (≤ 100 mg per day) inhibits COX-1 more than it inhibits COX-2 38,39 . Low-dose aspirin is used to prevent coronary syndromes and cerebral infarcts in patients who are at high risk of developing these disorders 38,40 . While high-dose aspirin use does confer anti-inflammatory effects, it is rarely used in clinical practice due to the high risk of adverse effects, which include gastric ulcers and hemorrhagic stroke 39,41 .…”
Section: Discussionmentioning
confidence: 99%
“…Thus, two of the major advances in clinical medicine over the last 50 years can be traced back to the work described in Vane's Gaddum Lecture. It is worth noting that both lowdose aspirin (Bibbins-Domingo, 2016;Iacono et al, 2019;Seidu et al, 2019) and the RAS inhibitors (Ferrario & Mullick, 2017;Esser & Zraika, 2019;. Stolfo & Savarese, 2019) are still providing clinical benefit to many millions of patients worldwide.…”
Section: Discussionmentioning
confidence: 99%