Aspirin for primary prevention of cardiovascular events in patients with diabetes: A meta-analysis

Zhang, Chunyu; Sun, Aijun; Zhang, Peng; Wu, Chaoneng; Zhang, Shuning; Fu, Mingqiang; Wang, Keqiang; Zou, Yunzeng; Ge, Junbo

doi:10.1016/j.diabres.2009.09.029

« Previous Next »Diabetes Research and Clinical Practice
Volume 87, Issue 2 , Pages 211-218, February 2010

Aspirin for primary prevention of cardiovascular events in patients with diabetes: A meta-analysis

Chunyu Zhang
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital; Fudan University, 180 Fenglin Road, Shanghai 200032, China
- These authors contributed equally to this work.
Aijun Sun
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital; Fudan University, 180 Fenglin Road, Shanghai 200032, China
- These authors contributed equally to this work.
Peng Zhang
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital; Fudan University, 180 Fenglin Road, Shanghai 200032, China
Chaoneng Wu
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital; Fudan University, 180 Fenglin Road, Shanghai 200032, China
Shuning Zhang
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital; Fudan University, 180 Fenglin Road, Shanghai 200032, China
Mingqiang Fu
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital; Fudan University, 180 Fenglin Road, Shanghai 200032, China
Keqiang Wang
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital; Fudan University, 180 Fenglin Road, Shanghai 200032, China
Yunzeng Zou
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital; Fudan University, 180 Fenglin Road, Shanghai 200032, China
- Institute of Biomedical Science, Fudan University, 138 Yixueyuan Road, Shanghai 200032, China
Junbo Ge
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital; Fudan University, 180 Fenglin Road, Shanghai 200032, China
- Institute of Biomedical Science, Fudan University, 138 Yixueyuan Road, Shanghai 200032, China
- Corresponding author at: Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital; Fudan University, 180 Fenglin Road Shanghai 200032, China. Tel.: +86 21 6404 1990x2745; fax: +86 21 6443 7078.

Received 3 September 2009; accepted 28 September 2009. published online 26 October 2009.

Abstract

Background

To systematically review trials concerning the benefit and risk of aspirin therapy for primary prevention of cardiovascular events in patients with diabetes mellitus.

Methods

We searched MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. Eligible studies were prospective, randomized controlled trials of aspirin therapy for primary cardiovascular prevention in patients with diabetes with follow-up duration at least 12 months.

Results

7 trials included 11,618 individuals with diabetes. Aspirin therapy was not associated with a statistically significant reduction in major cardiovascular events (relative risk [RR] 0.92, 95% confidence interval [CI] 0.83–1.02, p=0.11). Aspirin use also did not significantly reduce all-cause mortality (0.95, 95% CI 0.85–1.06; p=0.33), cardiovascular mortality (0.95, 95% CI 0.71–1.27; p=0.71), stroke (0.83, 95% CI 0.63–1.10; p=0.20), or myocardial infarction (MI) (0.85, 95% CI 0.65–1.11; p=0.24). There was no significant increased risk of major bleeding in aspirin group (2.46, 95% CI 0.70–8.61; p=0.16). Meta-regression suggested that aspirin agent could reduce the risk of stroke in women and MI in men.

Conclusions

In patients with diabetes, aspirin therapy did not significantly reduce the risk of cardiovascular events without an increased risk of major bleeding, and showed sex-specific effects on MI and stroke.

Keywords: Aspirin, Diabetes mellitus, Meta-analysis