New development of aspirin for the primary prevention of cardiovascular events in people with diabetes

Diabetes is well known to be the major risk factor of cardiovascular disease (CVD). The clinical use of aspirin is already quite common in diabetes for secondary prevention of coronary heart disease under much strong evidence being corroborated. In recent two years, there were several large-scale clinical trials published for the clinical use of aspirin directly to diabetic patients in primary prevention. Although there was no statistically significant data of aspirin in reducing the risk of CVD, aspirin was an independent associated factor in reducing all-cause mortality and CVD mortality reported in the Fremantle Diabetes Study (FDS). Aspirin was also an independent associated factor in reducing all-cause mortality in the subgroup analysis of more than 65-year-old patient, as well as men in the FDS. But in the study of Leung et al. in Hong Kong, aspirin had not only failed to reduce vascular events but also increased their hazard ratio. Although aspirin could increase the chance of bleeding, the risk was not high, and the all-cause mortality didn't reach the statistical significance, neither. Otherwise, in the study of Leung et al., aspirin could increase the chance of gastrointestinal bleeding, and reached statistical significance. Therefore, the low-dose aspirin for primary prevention of CVD in diabetic patients has a certain part of the positive help, but there is still the risk of bleeding. It is proposed to do in accordance with the use of patients with the number of risk factor of CVD and previous history of gastrointestinal bleeding, in which patients receive the maximum benefits.