Arquivos Brasileiros de Endocrinologia & Metabologia
On-line version ISSN 1677-9487
CAMARGO, Eduardo G. et al. Low-dose aspirin in patients with diabete melitus: risks and benefits regarding macro and microvascular complications. Arq Bras Endocrinol Metab [online]. 2007, vol.51, n.3, pp. 457-465. ISSN 1677-9487. http://dx.doi.org/10.1590/S0004-27302007000300015.
Aspirin is recommended as cardiovascular disease prevention in patients with diabetes mellitus. Due to the increased risk of bleeding and because of the hypothesis that there could be a worsening of microvascular complications related to aspirin, there has been observed an important underutilization of the drug. However, it is now known that aspirin is not associated with a deleterious effect on diabetic retinopathy and there is evidence indicating that it also does not affect renal function with usual doses (150 mg/d). On the other hand, higher doses may prove necessary, since recent data suggest that diabetic patients present the so called "aspirin resistance". The mechanisms of this resistance are not yet fully understood, being probably related to an abnormal intrinsic platelet activity. The employment of alternative antiplatelet strategies or the administration of higher aspirin doses (150-300 mg/d) should be better evaluated regarding effective cardiovascular disease prevention in diabetes as well as the possible effects on microvascular complications.
Keywords : Diabetes mellitus; Aspirin; Diabetic nephropathy; Cardiovascular prevention; Diabetic retinopathy.