Adults with Type 2 diabetes and elevated cardiovascular risk who took low-dose aspirin were less likely to experience a major cardiovascular event, including heart attack, stroke, or death, compared to those who did not take aspirin, according to preliminary research to be presented at the American Heart Association’s Scientific Sessions 2025.
The study, which analyzed 10 years of electronic health records from over 11,500 adults with Type 2 diabetes and moderate-to-high cardiovascular risk, found that any low-dose aspirin use was linked to a significantly lower risk of heart attack and stroke. Among those who took low-dose aspirin, 42.4% had a heart attack versus 61.2% in the non-aspirin group, and 14.5% had a stroke compared to 24.8%. The risk of death from any cause within 10 years was also lower: 33% in the aspirin group versus 50.7% in the non-aspirin group.
“We were somewhat surprised by the magnitude of the findings,” said lead author Aleesha Kainat, M.D., clinical assistant professor of medicine at the University of Pittsburgh Medical Center. The benefit was greatest for those who took aspirin most consistently.
Subgroup analysis showed that low-dose aspirin use was associated with lower cardiovascular event risk regardless of blood sugar levels, but the reduction was more substantial in individuals with better-controlled diabetes, as indicated by lower HbA1c levels. However, the study excluded people at high bleeding risk and did not track bleeding events, a key consideration given aspirin’s known bleeding risk.
The American Heart Association currently does not recommend low-dose aspirin for primary prevention in adults with Type 2 diabetes without established cardiovascular disease. “This study raises some good questions for further research and validation,” said Amit Khera, M.D., chair of the AHA’s Advocacy Coordinating Committee. “The clear message is to always work directly with your health care team.”
The findings are considered preliminary until published in a peer-reviewed journal, and the observational design cannot prove causation. More research is needed to balance cardiovascular benefits with bleeding risks and to explore interactions with newer diabetes therapies like GLP-1 medications.
Details of the study, including funding and disclosures, are available in the abstract presented at the meeting.
