Aspirin for Primary Cardiovascular Risk Prevention and Beyond in Diabetes Mellitus
Daily administration of low-dose of aspirin has proven to be beneficial in preventing recurrent cardiovascular events. However, the role of aspirin for primary prevention in patients with no overt cardiovascular disease is more controversial. In fact, in lower risk patients, the modest benefit in reducing serious vascular events can be offset by the increased risk of bleeding, including intracranial and gastrointestinal hemorrhage. Diabetes mellitus (DM) has been associated with a substantially increased risk of both first and recurrent atherothrombotic events, which makes aspirin therapy of potential value in these subjects. Moving from general aspects of aspirin pharmacology and specific issues in DM, this article reviews the literature on the topic of aspirin for primary prevention in general, and in subjects with DM in particular, to end up with arguments pro and con, and a practical risk-based algorithm for aspirin initiation in daily practice.
- Received July 11, 2016.
- Revision received August 11, 2016.
- Accepted August 30, 2016.