Document Detail


Aspirin for primary prevention of cardiovascular disease in diabetes mellitus.
MedLine Citation:
PMID:  20856266     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Aspirin is effective for the prevention of cardiovascular events in patients with a history of vascular disease, as so-called secondary prevention. In general populations with no history of previous myocardial infarction or stroke, aspirin also seems useful for primary prevention of cardiovascular events, although the absolute benefits are smaller than those seen in patients with previous cardiovascular disease. Patients with diabetes mellitus are at an increased risk of cardiovascular events, but new trials have raised questions about the benefit of aspirin for primary prevention in patients with this disorder. This Review comprehensively examines the basic pharmacology of aspirin and provides an overview of the randomized, controlled trials of aspirin therapy that have included patients with diabetes mellitus. On the basis of currently available evidence from primary prevention trials, aspirin is estimated to reduce the relative risk of myocardial infarction and stroke by about 10% in patients with diabetes mellitus; however, aspirin also increases the risk of gastrointestinal bleeding. As such, low-dose aspirin therapy (75-162 mg) is reasonable for patients with diabetes mellitus and a 10-year risk of cardiovascular events >10%. Results from upcoming large trials will help clarify the effects of aspirin with greater precision, including whether the benefits differ between men and women.
Authors:
Michael Pignone; Craig D Williams
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-09-21
Journal Detail:
Title:  Nature reviews. Endocrinology     Volume:  6     ISSN:  1759-5037     ISO Abbreviation:  Nat Rev Endocrinol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-21     Completed Date:  2011-01-28     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  101500078     Medline TA:  Nat Rev Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  619-28     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of North Carolina, 5039 Old Clinic Building, CB7110, Chapel Hill, NC 27599-7110, USA. michael_pignone@med.unc.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aspirin / adverse effects,  pharmacology,  therapeutic use*
Cardiovascular Diseases / prevention & control*
Diabetes Complications / prevention & control*
Drug Resistance
Female
Gastrointestinal Hemorrhage / chemically induced
Humans
Male
Middle Aged
Myocardial Infarction / epidemiology,  prevention & control
Practice Guidelines as Topic
Primary Prevention
Randomized Controlled Trials as Topic
Risk Factors
Stroke / epidemiology,  prevention & control
Grant Support
ID/Acronym/Agency:
K05 CA129166-04/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
50-78-2/Aspirin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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