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Aspirin does not prevent a first myocardial infarction or stroke in patients with diabetes

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Low- dose aspirin does not prevent a first myocardial infarction or stroke in patients with type 2 diabetes, according to Japanese researchers

Many guidelines recommend aspirin for people with diabetes because of their increased risk of myocardial infarction. For example, Diabetes UK currently recommends aspirin treatment for adults with diabetes over the age of 50 and some younger people depending on their risk factors. However, this is under review.

The new study found that, in patients younger than 65, the medication made no difference.

Researchers followed a total of 2,539 patients with type 2 diabetes and no history of atherosclerotic disease from across Japan for more than five years.

A group of 1,262 individuals were given 81mg or 100mg of aspirin a day while the other group received none. During the study, 154 atherosclerotic events occurred – 68 in the aspirin group and 86 in the non-aspirin group – producing a non-significant risk reduction that did not appear to justify the increased risk of gastrointestinal bleeds associated with the drug.

‘In this study of patients with type 2 diabetes, low-dose aspirin as primary prevention did not reduce the risk of cardiovascular events,’ the authors said.

Ellen Mason, senior cardiac nurse at the British Heart Foundation, said: ‘This study supports emerging evidence that aspirin does not appear to prevent first heart attacks and strokes in people with diabetes.

But she added: ‘Low-dose aspirin continues to be an important treatment for people who have known heart disease, whether they have diabetes or not.’

A similar Scottish study on patients, aged over 40 with either type 1 and 2 diabetes, was published in the BMJ in October. It found that those given low-dose aspirin were as likely to die from heart disease or experience a stroke, non-fatal heart attack or limb amputation as those taking a placebo.

Journal of the American Medical Association (2008) 300: 2134–2141

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