Diabetes: Aspirin Heart Perk Questioned

Studies Show Low-Dose Aspirin May Not Lower Heart Risks in Diabetes Patients With No History of Heart Disease

By Miranda Hitti
WebMD Health News

Reviewed By Elizabeth Klodas, MD, FACC

Nov. 10, 2008 -- Taking low-dose aspirin may not prevent diabetes patients from experiencing heart "events," new research shows.

Those findings come from a new study published in The Journal of the American Medical Association and another study published last month in BMJ. Those two studies don't question the heart benefits of low-dose aspirin in people who already have heart disease. Instead, the new studies are about aspirin's effects on people with diabetes who have no history of heart disease.

The researchers aren't closing the door on aspirin for diabetes patients, but "the decision to prescribe aspirin should be made on an individual patient basis," states an editorial published in The Journal of the American Medical Association.

Aspirin, Diabetes, and Heart Disease

Diabetes makes heart disease more likely. So the two new studies tested whether taking low-dose aspirin helped prevent heart attacks and other cardiovascular events (strokes, death from heart disease, etc.) in diabetes patients without a history of heart disease.

One of the studies, published in The Journal of the American Medical Association, took place in Japan and included 2,539 adults with type 2 diabetes who typically stayed in the study for about four years.

The other study, published last month in BMJ's "Online First" edition, took place in Scotland and included 1,276 adults with type 1 or type 2 diabetes who were followed for about six years.

The studies were designed differently. The Japanese study didn't use a placebo, and half of the patients in the Scottish study also got antioxidant supplements.

But in both studies, the bottom line was the same: There was no sign that taking low-dose aspirin lessened the patients' odds of having their first cardiovascular event.

Still, that may not be the final word on the topic.

For instance, the Japanese study had fewer cardiovascular events than expected, which might have made it harder to trace aspirin's effects. And in the Scottish study, the researchers note that "small effects may be shown with larger trials continued for a longer time."

Editorialists Weigh In

In BMJ, editorialist William Hiatt, MD, a professor of medicine at the University of Colorado Denver School of Medicine, writes that "although aspirin is cheap and universally available," it should only be prescribed for patients "with established symptomatic cardiovascular disease."

But in The Journal of the American Medical Association, editorialist Antonio Nicolucci, MD, of Italy's Consorzio Mario Negri Sud encourages doctors and diabetes patients to weigh the pros and cons of low-dose aspirin on a case-by-case basis until further research is available.

SOURCES: Ogawa, H. The Journal of the American Medical Association, Nov. 12, 2008; vol 300: pp 2134-2141. Nicolucci, A. The Journal of the American Medical Association, Nov. 12, 2008; vol 300: pp 2180-2181. Belch, J. BMJ Online First, Oct. 17, 2008. Hiatt, W. BMJ Online First, Oct. 17, 2008.

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