Comment why do recommendations on aspirin for people with diabetes differ?
In this article published early online in the European Heart Journal, the authors discuss how recommendations made by major European and US scientific societies on the use of aspirin for the primary prevention of CV disease in diabetics are ‘totally divergent’. The US statement recommends the use of aspirin for primary prevention in all individuals aged >40 or with additional risk factors. In contrast, in the European guidelines there is no mention of aspirin for the primary prevention of myocardial infarction or CV death, while it is recommended for the prevention of stroke.
The authors comment: ‘existing knowledge is mainly derived from dated trials, including small numbers of patients, and hardly representing current strategies for the management of CV risk factors. The high level of uncertainty regarding the balance between benefits and risks of aspirin therapy have important implications for clinical practice, auditing activities, and the design and conduct of randomized clinical trials’.