Last update:
22-Mar-2022

It is well established that people with diabetes mellitus (DM) are at increased risk of cardiovascular disease compared with those without DM. Although the protective role of aspirin in secondary prevention is well documented, its role in the primary prevention of cardiovascular disease in people with DM is unclear, even after publication of the results of major clinical trials and meta-analyses. The observed discrepancies may be explained in part by the differences between the study populations in terms of the background cardiovascular risks, age and gender, and the follow-up periods. Recently, the results of the ASCEND (A Study of Cardiovascular Events in People with Diabetes) trial in people with DM documented the cardiovascular benefit of aspirin for primary prevention, but with an increased risk of bleeding that might outweigh the observed cardiovascular benefit. The current guidelines, therefore, recommend its use for primary prevention in people with and without DM under specific circumstances. This review summarizes the current literature on the place of aspirin in the primary prevention of cardiovascular disease in people with DM.

Key words: Aspirin, Cardiovascular disease, Diabetes mellitus, Myocardial infarction, Primary cardiovascular prevention, Stroke.