Not All Patients with DM (Diabetes Mellitus) May Need Aspirin

It is widely recommended by guidelines from European and some other cardiology organizations that patients with DM, especially those with at least one other cardiovascular risk factors, should consider to have aspirin treatment to reduce the risk of Coronary Artery Diseases (CAD).

Definitely, this treatment for patients with DM is guaranteed by hundreds of thousands of clinical tests for its advantages to the secondary prevention to CAD. However one question arises from the situation that whether the CAD status should be considered when suggesting patients with DM to take the aspirin treatment?

One recent research by experts in Netherlands shows that in 425 patients at high risk with DM (without chest pain syndrome or a history of cardiac disease), 27% had no CAD (stenosis < 30%), 37.5% had nonobstructive CAD (stenosis 30-49%), and only 35% had obstructive CAD (stenosis ≥50%). In most countries, it is accepted that aspirin is only useful if coronary atherosclerosis is present and acts in case of a thrombotic event which always indicates that the stenosis is larger and equal than 50%. Moreover, in a population-based cohort study, patients with DM had an increased risk of major bleeding compared to patients with DM. Through this result, if obstructive CAD (stenosis ≥50%) would have been selected as a cut off for stratification of patients, in 65% of patients aspirin use could have been avoided.

The research group suggested the patients with DM should monitor the CAD status to lower the risk of gastrointestinal bleeding when tailoring the aspirin treatment by Computed Tomography Angiography (CTA) or screening patients by assessing the Coronary Artery Calcium (CAC) score.

The treatment for primary prevention to CAD in patients with DM is still the research focus in world medical centers, and an increasing number of experts suggested people to have the daily care such as physical exercises, healthy life style, and avoidance of CAD risk factors, meanwhile, taking the safe and natural healthcare supplements like Salvia miltiorrhiza is another considerate advice for a better primary prevention to coronary artery diseases (more infos will come up, keep eyes on us).

Do you regularly have aspirin in your daily life? Do you have any family members or friends who are taking aspirin against CVD with diabetes mellitus? Don’t hesitate to forward this thread to make help.