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Diabetes Standards of Care & Clinical Practice Resources

Aspirin and Other Antiplatelet Therapy

Antiplatelet therapy, including aspirin and clopidogrel, may be used to reduce the risk of cardiovascular disease (CVD) events in appropriate patients with diabetes.

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Clinical Practice Recommendations

Secondary Prevention

  • Patients with a history of Atherosclerotic Cardiovascular Disease (ASCVD)* should receive aspirin 75-162mg who are not at increased risk of bleeding.
  • If allergic to aspirin, consider clopidogrel 75mg daily.

Primary Prevention

  • Consider aspirin 75-162mg in patients with increased risk of ASCVD, (e.g., age ≥ 50 years and one or more risk factors**), who are not at increased risk of bleeding.
  • Aspirin is not recommended in patients at lower risk of ASCVD, (e.g., age < 50 years with no other major ASCVD risk factors**).

* ASCVD is atherosclerosis affecting the vasculature of any of the following: the heart, periphery (e.g., legs, carotids), and the brain (e.g., stroke, transient ischemic attack).
** Risk factors include: family history of premature ASCVD, hypertension, dyslipidemia, smoking, or albuminuria.

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