Antiplatelet Management in Diabetes Mellitus

Aka: Antiplatelet Management in Diabetes Mellitus, Aspirin Use in Diabetes

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II. Background

  1. Aspirin has historically been considered in all diabetic patients or starting at age 45 years in men and age 55 years in women
  2. However consider benefit of 7 years Aspirin (1 less CV event in 90) versus life threatening bleeding risk (1 in 110)
    1. (2018) Presc Lett 25(11): 61

III. Indications: Low dose Aspirin 81 mg daily (more specific as of 2012)

  1. Framingham risk >10%, no vascular disease, and no Bleeding Diathesis
  2. Males over age 50 years or females over age 60 years and
  3. One additional Cardiovascular Risk Factor
    1. Tobacco Abuse
    2. Hypertension
    3. Dyslipidemia
    4. Albuminuria
    5. Family History of premature cardiovascular death

IV. Indications: Clopidogrel (Plavix) 75 mg daily

  1. Known cardiovascular disease

V. Adverse Effects

  1. See Aspirin
  2. Aspirin does not increase risk of Retinal Hemorrhage

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