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Aspirin, Antioxidants Don't Prevent Diabetic Cardiac Death

Primary prevention of cardiovascular disease with aspirin in diabetic patients not beneficial

FRIDAY, Oct. 17 (HealthDay News) -- Neither aspirin nor antioxidants are effective in the primary prevention of cardiovascular events among diabetics with asymptomatic peripheral arterial disease, according to research published Oct. 16 in BMJ Online First.

Jill Belch, M.D., of the University of Dundee in the United Kingdom, and colleagues randomized 1,276 asymptomatic patients with type 1 or type 2 diabetes and an ankle brachial pressure index of 0.99 or less, to one of four treatment conditions: 100 mg aspirin tablet plus antioxidant capsule; aspirin tablet plus placebo capsule; placebo tablet plus antioxidant capsule; or placebo tablet plus placebo capsule.

Overall, there were no significant differences in death from coronary heart disease or stroke, non-fatal myocardial infarction or stroke, or amputation above the ankle for critical limb ischemia for either the aspirin or no aspirin groups or the antioxidant or no antioxidant groups, the investigators found. Similarly, there were no significant differences in death from heart disease or stroke in the aspirin compared to no aspirin groups or in the antioxidant compared to no antioxidant groups, the authors report.

In an accompanying editorial, William R. Hiatt, M.D., of the University of Colorado Denver School of Medicine, comments that "a total of seven well-controlled trials now show that aspirin has no benefit for primary prevention of cardiovascular events, even in people at higher risk. Although aspirin is cheap and universally available, practitioners and authors of guidelines need to heed the evidence that aspirin should be prescribed only in patients with established symptomatic cardiovascular disease."

Bayer and Scotia Pharmaceuticals donated medication and placebo to the study.

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