Use of Aspirin to Reduce Risks of Cardiovascular Disease in Patients With Diabetes Clinical and research challenges

摘要: In their third version of U.S. federal guidelines, the National Cholesterol Education Program Adult Treatment Panel III elevated diabetes from a major risk factor to coronary heart disease (CHD) equivalent (1, 2). The rationale for this change derives, in part, earlier observations that patients with have several-fold increased risks CHD (3), which are even greater women than men (4). fact, it has been suggested at any given age, eliminates lower absolute compared men. Specifically, middle-aged woman an approximately equal her male counterpart without diabetes. Furthermore, prospective cohort study, nondiabetic subjects prior had 7-year event rate ∼18.8%, whereas diabetic ∼20% (5). Whether such high apply newly diagnosed is less clear. Nonetheless, current guidelines recommend be treated just as aggressively secondary prevention (i.e., those who already experienced event). With respect prevention, aspirin conclusively reduces subsequent myocardial infarction (MI) by about one-third, stroke one-fourth, and vascular death one-sixth (6, 7). primary first MI but numbers strokes deaths five published trials preclude firm conclusions. based on meta-analyses (8) benefits (9), recent Preventive Services Task Force Guidelines also considered all apparently …