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Heart 98:1325 doi:10.1136/heartjnl-2012-302732
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General cardiology

Aspirin use and major bleeding

The American Diabetes Association recommends low-dose aspirin (75–162 mg/day) for adults with diabetes and no previous history of vascular disease, but with a 10-year risk of cardiovascular events >10% and who do not have an increased risk of bleeding. However, as the benefits of low-dose aspirin in the primary prevention setting are modest, any benefit of low-dose aspirin could be offset by the risk of bleeding. This study aimed to determine the incidence of major gastrointestinal and intracranial bleeding episodes in individuals with and without diabetes who were taking aspirin.

Administrative data were used from 4.1 million citizens in Puglia, Italy. Individuals with new prescriptions for low-dose aspirin (≤300 mg) were identified during the index period from 1 January 2003 to 31 December 2008 and were propensity-matched on a one-to-one basis with individuals who did not take aspirin over this period. The main outcomes measure was hospitalisations for major gastrointestinal bleeding or cerebral haemorrhage.

186 425 individuals taking low-dose aspirin were compared with 186 s425 matched controls who were not using aspirin; median follow-up was 5.7 years. The overall incidence rate of haemorrhagic events was 5.58 (95% CI 5.39 to 5.77) per 1000 person-years for aspirin users and 3.60 (95% CI 3.48 to …

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