Evidence map›Paper›PMID 19897665›Full record

SynthesisBMJ (Clinical research ed.)2009

Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomised controlled trials.

Giorgia De Berardis, Michele Sacco, Giovanni F M Strippoli, Fabio Pellegrini, Giusi Graziano, Gianni Tognoni, Antonio Nicolucci

Erratum issuedOpen access · hybridAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 115 papers, 24 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
115citing papers in PubMed, 24 pooled it
30.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

115 citing papers in PubMed, 24 syntheses or guidelines pooled it, 396 citations in OpenAlex.

  1. Guideline
  2. Guideline
  3. Pooled it
  4. Guideline
  5. Aspirin for primary prevention of stroke in individuals without cardiovascular disease-A meta-analysis.International journal of stroke : official journal of the International Stroke Society · 2020
    Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Atencion primaria · 2018
    Guideline
  10. Aspirin and the Primary Prevention of Cardiovascular Diseases: An Approach Based on Individualized, Integrated Estimation of Risk.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2017
    Guideline
  11. Pooled it
  12. Guideline
  13. Pooled it
  14. A systematic review of aspirin in primary prevention: is it time for a new approach?American journal of cardiovascular drugs : drugs, devices, and other interventions · 2015
    Pooled it
  15. Guideline
  16. Pooled it
  17. Pooled it
  18. Guideline
  19. Guideline
  20. Guideline

55 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Giorgia De BerardisDepartment of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale 8/a, 66030 S. Maria Imbaro, Italy.
Michele Sacco
Giovanni F M Strippoli
Fabio Pellegrini
Giusi Graziano
Gianni Tognoni
Antonio Nicolucci
Mario Negri Sud Foundation · ITUniversity of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the benefits and harms of low dose aspirin in people with diabetes and no cardiovascular disease.

designMeta-analysis of randomised controlled trials. DATA SOURCES: Medline (1966-November 2008), the Cochrane central register of controlled trials (Cochrane Library 2008;issue 4), and reference lists of retrieved articles. Review methods Randomised trials of aspirin compared with placebo or no aspirin in people with diabetes and no pre-existing cardiovascular disease were eligible for inclusion. Data on major cardiovascular events (death from cardiovascular causes, non-fatal myocardial infarction, non-fatal stroke, and all cause mortality) were extracted and pooled with a random effect model. Results are reported as relative risks with 95% confidence intervals.

resultsOf 157 studies in the literature searches, six were eligible (10 117 participants). When aspirin was compared with placebo there was no statistically significant reduction in the risk of major cardiovascular events (five studies, 9584 participants; relative risk 0.90, 95% confidence interval 0.81 to 1.00), cardiovascular mortality (four studies, n=8557, 0.94; 0.72 to 1.23), or all cause mortality (four studies, n=8557; 0.93, 0.82 to 1.05). Significant heterogeneity was found in the analysis for myocardial infarction (I(2)=62.2%; P=0.02) and stroke (I(2)=52.5%; P=0.08). Aspirin significantly reduced the risk of myocardial infarction in men (0.57, 0.34 to 0.94) but not in women (1.08, 0.71 to 1.65; P for interaction=0.056). Evidence relating to harms was inconsistent.

conclusionsA clear benefit of aspirin in the primary prevention of major cardiovascular events in people with diabetes remains unproved. Sex may be an important effect modifier. Toxicity is to be explored further.

Indexed as

AspirinCardiovascular AgentsDiabetic AngiopathiesFemaleHumansMalePrimary PreventionPrognosisProspective StudiesRandomized Controlled Trials as TopicRisk FactorsAspirinCardiovascular Agents

Identifiers

PMID19897665
PMCPMC2774388
OpenAlexW2102397849

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.