Aspirin in primary prevention for patients with diabetes: Still a matter of debate

European Journal of Clinical Investigation
Aldo BonaventuraFabrizio Montecucco

Abstract

Patients with diabetes are at high cardiovascular (CV) risk due to an exaggerated platelet activation and aggregation. In the first 2000s low-dose aspirin was first recommended for primary prevention, but then re-discussed. This short narrative review, based on the material searched for and obtained via PubMed up to February 2018, aims at clarifying this controversial topic. The JPAD2 study has been designed to evaluate the occurrence of any CV event in a cohort of patients with diabetes and concluded that low-dose aspirin did not influence the risk for CV events while increasing the risk for gastrointestinal (GI) bleeding. Reasons for this result can be found in the role of diabetic platelets, which are known to be hyperreactive, thus producing intensified adhesion, activation, and aggregation. In this setting, other associated metabolic conditions can concur to enhance platelet adhesion and activation. Aspirin resistance has been often considered a guilty actor, although many mechanisms have been mistaken for true aspirin resistance, such as patient poor compliance, inadequate dosing, drug interactions, and high-platelet turnover. However, the mere presence of diabetes is not likely to give a net benefit for CV protection wit...Continue Reading

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Citations

Mar 19, 2019·European Journal of Clinical Investigation·Max-Paul WinterJolanta M Siller-Matula
Apr 22, 2019·Diabetic Medicine : a Journal of the British Diabetic Association·L VernstrømK L Funck
Sep 1, 2019·Current Pharmaceutical Design·Alessandra VecchiéAldo Bonaventura
Jan 23, 2020·Cells·Aldo BonaventuraFabrizio Montecucco
Jun 9, 2020·European Journal of Clinical Investigation·Gloria M GagerJolanta M Siller-Matula

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