University Hospital South Manchester, Wythenshawe Hospital, Department of Diabetes & Endocrinology, Southmoor Road, Manchester M23 9LT, UK.
Expert Opin Pharmacother. 2010 Jun;11(9):1459-66. doi: 10.1517/14656561003792538.
To evaluate the benefits of aspirin in people with diabetes mellitus for the primary prevention of cardiovascular disease.
RESEARCH DESIGN/METHODS: We searched MEDLINE and Cochrane database for randomized, controlled trials of aspirin in people with diabetes and no cardiovascular disease. Relative risks were determined using random-effects meta-analysis.
Risk reduction of aspirin compared with control groups for major cardiovascular events.
Six trials consisting of 7374 patients with diabetes showed no benefits of aspirin compared with non-aspirin users with regard to overall mortality, risk reduction (relative risk (RR) = 0.96, 95% CI 0.78 - 1.18, p = 0.71), major cardiovascular events (RR = 0.90, 95% CI 0.78 - 1.05, p = 0.17) and myocardial infarction (RR = 0.95, 95% CI 0.76 - 1.18, p = 0.63). Risk of major bleeding in the aspirin compared with the non-aspirin group was not significant (RR = 2.49, 95% CI 0.70 - 8.84, p = 0.16).
Aspirin therapy did not reduce the risk of cardiovascular events. Existing trials were limited by small patient numbers and low cardiovascular event rates. The use of aspirin cannot be routinely recommended for primary prevention of cardiovascular events in diabetes.
评估阿司匹林对无心血管疾病的糖尿病患者在心血管疾病一级预防中的获益。
研究设计/方法：我们检索了 MEDLINE 和 Cochrane 数据库中关于阿司匹林治疗糖尿病患者的随机对照试验。采用随机效应荟萃分析确定相对风险。
与对照组相比，阿司匹林在减少主要心血管事件方面的风险。
六项包含 7374 例糖尿病患者的试验表明，与非阿司匹林使用者相比，阿司匹林并未带来整体死亡率、风险降低（相对风险（RR）=0.96，95%CI 0.78-1.18，p=0.71）、主要心血管事件（RR=0.90，95%CI 0.78-1.05，p=0.17）和心肌梗死（RR=0.95，95%CI 0.76-1.18，p=0.63）方面的获益。阿司匹林组与非阿司匹林组大出血风险无显著差异（RR=2.49，95%CI 0.70-8.84，p=0.16）。
阿司匹林治疗并未降低心血管事件风险。现有试验受到患者数量少和心血管事件发生率低的限制。阿司匹林不能常规推荐用于糖尿病患者的心血管事件一级预防。
