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Low-dose aspirin and ischaemic stroke in diabetes

Pragmatically, aspirin appears to be an appropriate choice for people with diabetes, given their increased cardiovascular risk, but its prescription is not supported by a sound evidence base. Several trials have assessed this clinical issue, and some have reported harm from aspirin. In this latest retrospective cohort study, a population-based study in Korea, the use of low-dose aspirin was associated with an increased risk of hospitalisation for ischaemic stroke. These results suggest that low-dose aspirin use for the primary prevention of ischaemic stroke should be reconsidered in people with diabetes.

by Colin Kenny, GP, Dromore

The role of aspirin in the prevention of cardiovascular events in people with diabetes is much debated. NICE still recommends it in people over 50 and those at high risk, but outcome evidence for its successful use is limited. Now, a large Korean analysis has further questioned its safety by finding an increased risk of hospitalisation with ischaemic stroke in those using aspirin.

Researchers in this study performed a retrospective analysis of 261,065 incident cases of diabetes; 15,849 (6.2%) individuals were using low-dose aspirin users. Compared with non-users, the low-dose aspirin users had a significantly higher risk of ischaemic stroke.  In subgroup analyses, sex, age, and comorbidity status did not have an impact on the risk of hospitalisation for ischaemic stroke. These results suggest that low-dose aspirin use for the primary prevention of ischemic stroke should be reconsidered in people with diabetes.

To access the full publication, click here

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