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Higher aspirin resistance in diabetes

The standard dose of aspirin may not be adequate to protect those with diabetes against a future myocardial infarction (MI) researchers have found. Aspirin is generally considered as a standard treatment for preventing and treating MIs but a study from the Sinai Hospital of Baltimore, MD, USA, recently demonstrated that aspirin resistance, at the standard dose of 8 mg, is higher in diabetics with coronary artery disease (CAD) than in nondiabetics. The standard aspirin dose may be insufficient in diabetics to achieve adequate blockade of cyclooxygenase-1. Paul A Gurbel, lead author of the study, advises that “the occurrence of clotting in patients on aspirin therapy is of major interest within the cardiovascular community. The effect of aspirin dosing in diabetic patients on the prevalence of aspirin remains unclear.” He then added, “our data suggest that there may be a higher risk of thrombosis in diabetic patients during low-dose aspirin therapy.” A total of 120 aspirin-treated patients with stable CAD were observed throughout the study. Of these, 30 had diabetes. Patients had their response to aspirin assessed over a 12-week period after being administered 81, 162 and 325 mg of aspirin daily each for a 4-week period. The results demonstrated that patients with diabetes displayed an elevated level of aspirin resistance when administered the 81-mg dose of aspirin compared with nondiabetic patients. Gurbel concludes, “the results of our findings may help to determine the best aspirin dose for diabetic patients, moving away from the one-size-fits-all approach to aspirin therapy.”