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Use of aspirin for primary prevention of cardiovascular disease in diabetes

The use of aspirin for primary prevention of cardiovascular disease in people with diabetes; a single patient meta-analysis of randomised controlled and observational studies

What we are doing:

We will conduct an updated search of relevant databases to identify newer studies that have been published on the topic and invite potential investigators, with a dataset consisting of individual trials and variables included according to a predefined coding scheme. Variables to be included are descriptive characteristics of the study, intervention, comparison, participant characteristics and outcomes. We will perform an IPD meta-analysis to assess the treatment effect of aspirin on CVD and all-cause mortality in adults with diabetes. The primary outcome will be major adverse cardiovascular events (MACE).

Why we are doing it:

Given the high clinical interest of this topic and with the publication of newer trials since the last relevant meta-analysis on the topic, we aimed to address the persisting uncertainties on the benefits and harms of aspirin for the prevention of CVD and all-cause mortality events in people with diabetes by conducting an updated systematic meta-analysis using individual patient data (IPD).

What the benefits will be:

Our findings will be relevant and provide further insight on aspirin therapy in primary cardiovascular prevention therapy in diabetes, and may have implications for clinical practice.

There may be important differences in the effect of aspirin by dosage, treatment duration and sex, but the findings from our study and that of previous reviews have mostly been mixed, due to aggregation of insufficiently-powered studies and reporting of results from subgroup analyses. Due to the differences in the diabetes duration, co-morbidities and complications, single patient level meta-analysis will allow targeted individualised recommendations

Who we are working with:

  • Division of Preventive Medicine, Brigham and Women's Hospital
  • Instituto di Ricerche Farmacologiche Mario Negri, Milan, Italy

Study lead:

Name: Dr Sam Seidu 

Role: Research Fellow

Organisation: Diabetes Research Centre, University of Leicester

Contact:

setor.kunutsor@bristol.ac.uk