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Acetylsalicylic acid for patients with diabetes but without cardiovascular disease

Patients with diabetes are at increased risk of cardiovascular disease. One plausible option to prevent these cardiovascular diseases could be the use of acetylsalicylic acid as a primary prevention. Recent research has found evidence that the efficacy of this treatment is minimal, whereas the risk of haemorrhage is not negligible. In line with the Dutch guidelines, these findings do not support the use of acetylsalicylic acid in the primary prevention of cardiovascular diseases among patients with diabetes.

  • The study discussed here reported that the preventive use of acetylsalicylic acid did slightly reduce the number of first-time cardiovascular events among patients with diabetes. In order to prevent one cardiovascular event, 91 patients need to be treated with acetylsalicylic acid for about 7 years.
  • The slight reduction in the number of cardiovascular events that was found disappears when TIAs (which are clinically less serious) are excluded.
  • The Dutch guidelines do no recommend the preventive use of acetylsalicylic acid for patients with diabetes who do not suffer from cardiovascular disease. The study discussed here offers no arguments to adjust these guidelines.
  • The use of acetylsalicylic acid by relatively healthy patients with diabetes should not be recommended. Its benefits are minor and are offset by an increased risk of serious haemorrhage. 

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The literature refers to the Dutch text


  • Marielle A.E. Nieuwhof