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Low-doses aspirin in the primary prevention of cardiovascular disease in patients with diabetes: Meta-analysis stratified by baseline cardiovascular risk

2022; Elsevier BV; Volume: 16; Issue: 1 Linguagem: Inglês

10.1016/j.dsx.2022.102391

1878-0334

Walter Masson, Leandro Barbagelata, Augusto Lavalle Cobo, Martín Lobo, Gerardo Masson, Juan Patricio Nogueira, Bruno Vergès,

Cardiovascular Function and Risk Factors

The aim of this meta-analysis was to analyze the risks and benefits of low-dose aspirin in patients with T2D without cardiovascular conditions according to the baseline cardiovascular risk. We performed a meta-analysis including randomized clinical trials that evaluated the use of low-dose aspirin (75–100 mg/day) versus placebo/usual care in patients with T2D. Studies were classified as low, moderate and high risk based on the number of events in the placebo/control arms or by cardiovascular risk score when reported. The incidence of MACE, cardiovascular mortality and bleeding were evaluated. Ten eligible trials (34069 patients) were considered eligible for the analyses. According to the stratified analysis, low-dose aspirin use was associated with reduced risk for MACE in the moderate/high-risk group (OR: 0.88; 95% CI, 0.80–0.97; I2 = 0%) but not in the low-risk group (OR: 0.89; 95% CI, 0.77–1.01; I2 = 0%). Likewise, low-dose aspirin use was associated with more bleeding in the low-risk group, showing a non-significant trend in the moderate/high-risk group. There was no reduction in cardiovascular mortality in either group. Beyond the different findings in each stratum, the differences between the subgroups were not statistically significant. This study showed that low-dose aspirin in patients with T2D reduces MACE and increases bleeding. Based on the within-subgroups results, the baseline cardiovascular risk does not modify the effect of aspirin therapy. However, few studies were included and the comparison between subgroups showed a trend in favor to the highest risk group, these results should be confirmed in future studies.