Aspirin Cuts Heart Attack, Stroke Risk in Type 2 Diabetes Patients

A groundbreaking preliminary study to be presented at the American Heart Association's Scientific Sessions 2025 reveals that adults with Type 2 diabetes and moderate-to-high cardiovascular disease risk who took low-dose aspirin experienced significantly fewer major cardiovascular events compared to their peers who didn't take aspirin. The research, led by Dr. Aleesha Kainat from the University of Pittsburgh Medical Center, analyzed electronic health records of over 11,500 adults with Type 2 diabetes over a 10-year period, finding that aspirin users had substantially lower rates of heart attack (42.4% vs 61.2%), stroke (14.5% vs 24.8%), and death from any cause (33% vs 50.7%). The study highlights that the cardiovascular benefits were most pronounced among those who took low-dose aspirin consistently throughout the follow-up period, suggesting that regular use provides the greatest protection against these life-threatening events.

The research provides crucial insights into managing cardiovascular risk in the Type 2 diabetes population, particularly noting that the protective effects of low-dose aspirin were observed regardless of participants' blood sugar control levels, though the reduction was more substantial in individuals with better-controlled diabetes as indicated by lower HbA1c levels. Importantly, the study excluded individuals with high bleeding risk and didn't track bleeding events, which represents a significant limitation since aspirin's bleeding risk remains a critical consideration in clinical decision-making. Dr. Amit Khera of UT Southwestern Medical Center emphasized that while the American Heart Association doesn't currently recommend low-dose aspirin for primary prevention in adults with Type 2 diabetes without established cardiovascular disease, this study raises important questions for future research and validation, underscoring the need for individualized risk assessment with healthcare providers.

The study's findings are particularly relevant given that cardiovascular disease continues to be the leading cause of death among people with Type 2 diabetes, and diabetes itself represents a major risk factor for the recent rise in heart disease and stroke incidence. The research team used the Atherosclerotic Cardiovascular Disease risk score calculator from the American Heart Association and American College of Cardiology's 2018 special report to identify participants with moderate-to-high risk, analyzing data from the University of Pittsburgh Medical Center's extensive healthcare system spanning 35 hospitals and 400 outpatient clinics across Pennsylvania, Maryland, and West Virginia. As the study was observational rather than a clinical trial, the researchers caution that the findings cannot definitively prove causation, but they provide compelling real-world evidence supporting further investigation into low-dose aspirin's potential role in cardiovascular risk reduction for this high-risk population.