Aspirin and first heart attacks in diabetics

A large study out of Scotland has shown that aspirin and antioxidant supplements are ineffective in the primary prevention of heart attacks in people with diabetes and asymptomatic arterial disease.

An investigative team led by Jill Belch, professor of vascular medicine at the University of Dundee, conducted an eight-year study of 1,276 people aged 40 years and older with diabetes and evidence of artery disease but no symptomatic cardiovascular disease. The patients were randomized to receive daily aspirin (100 mg) or placebo, an antioxidant or placebo, aspirin and antioxidant, or double placebo. The antioxidant capsule contained a mixture of a-tocopherol, ascorbic acid, pyridoxine hydrochloride, zinc sulfate, nicotinamide, lecithin, and sodium selenite.

There were 116 primary events in the aspirin groups, compared with 117 among placebo-takers. Similarly, 117 primary events occurred in the antioxidant groups compared with 116 in the no-antioxidant groups.

A total of 43 deaths from coronary heart disease or stroke occurred in the aspirin groups compared with 35 in the no-aspirin groups (6.7% vs. 5.5%). The numbers were essentially the same for the antioxidant and no-antioxidant groups: 42 (6.6%) and 36 (5.7%), respectively.

“We found no evidence to support the use of either aspirin or antioxidants in the primary prevention of cardiovascular events and mortality in people with diabetes,” the researchers conclude (BMJ. 2008;337:a1840).
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