ANTIPLATELET AGENTS
Recommendations
c Consider aspirin therapy (75–162
mg/day) as a primary prevention
strategy in those with type 1 or
type 2 diabetes at increased cardiovascular
risk (10-year risk
.10%). This includes most men
aged .50 years or women aged
.60 years who have at least one
additional major risk factor (family
history of CVD, hypertension,
smoking, dyslipidemia, or albuminuria).
C
c Aspirin should not be recommended
for CVD prevention for
adults with diabetes at low CVD
risk (10-year CVD risk ,5%, such
as in men aged ,50 years and
women aged ,60 years with no
major additional CVD risk factors),
since the potential adverse effects
from bleeding likely offset the
potential benefits. C
c In patients in these age-groups
with multiple other risk factors
(e.g., 10-year risk 5–10%), clinical
judgment is required. E
c Use aspirin therapy (75–162 mg/day)
as a secondary prevention strategy
in those with diabetes and a history
of CVD. A
c For patients with CVD and documented
aspirin allergy, clopidogrel
(75 mg/day) should be used. B
c Dual antiplatelet therapy is reasonable
for up to a year after an
acute coronary syndrome. B