Low‑dose Aspirin for Primary Prevention of Cardiovascular Events in Postmenopausal Women with Type‑2 Diabetes: The Prescriptive Approach in the Real World

The long‑term efficacy of low‑dose aspirin for primary prevention of cardiovascular (CV) events in postmenopausal women with type‑2 diabetes is controversial. Therefore, it is recommended only on an individual basis, recommendation of grade C.

We enrolled 275 consecutive postmenopausal women with type‑2 diabetes, without an increased bleeding risk and without preexisting CV disease as coronary artery disease, stroke, and peripheral vascular disease, but with a high risk assessed by score >10%, aged 60–69 years. All were receiving aspirin (75–100 mg daily), aspirin group (AG). 170 postmenopausal women with type‑2 diabetes and without preexisting cardiovascular (CV) disease, but not on aspirin treatment, despite a high risk assessed by score >10%, were control group (CG). Mean age was 66 ± 4 years for AG and 65 ± 7 years for CG. Our goal was to identify the prevalence of low‑dose aspirin prescriptions in these populations according to different clinical conditions.

Women with only high risk were 41/275 (15%) on AG and 72/170 (42.3%) on CG, Chi‑squared 41, Odds ratio 0.2, c.i. 95%, P < 0.0001. Women affected by metabolic syndrome were 105/275 (38.1%) on AG and 47/170 (27.6%) on CG, Chi‑squared 5.1, Odds ratio 1.6, c.i. 95%, P < 0.02. Women affected by metabolic cardiomyopathy were 111/275 (40.3%) on AG and 44/170 (25.9%) on CG, Chi‑squared 8, Odds ratio 1.8, c.i. 95%, P < 0.004. Women affected by diabetic cardiomyopathy were 18/275 (6.6%) on AG and 7/170 (4.2%) on CG, Chi‑squared 1.2, Odds ratio 16, c.i. 95%, P < 0.2 n.s.

Low‑dose aspirin in our population is prescribed preferentially in postmenopausal women with type‑2 diabetes when affected by metabolic syndrome or metabolic cardiomyopathy, at the opposite women with only high risk have lower chance to receive aspirin.