Although the improved control of hyperglycaemia and other cardiovascular risk factors was associated with a parallel decline of atherosclerotic cardiovascular disease (ASCVD) and death in both type 1 (T1) and type 2 (T2) diabetes mellitus (DM), the burden of death and hospitalization for ASCVD remains significantly higher by about 2-fold versus the matched non-DM population. Life style interventions, such as physical activity and healthy diet, and drugs, such as statins and low-dose aspirin, may have beneficial effects by targeting one or multiple pathways responsible for accelerated atherosclerosis and its thrombotic complications. The debate on the benefit-risk balance of primary cardiovascular prevention with aspirin has been especially vivacious over the past two years, following the publication of three large randomized, placebo-controlled, primary prevention trials in different settings, spanning from healthy elderly to DM subjects. The aim of this review is to discuss the pathophysiological, pharmacological and clinical evidence supporting the appropriate use of low-dose aspirin in DM, within the context of the current multifactorial approach to primary cardiovascular prevention.

中文翻译：

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阿司匹林在糖尿病心血管疾病的一级预防中：一个新的视角。

尽管对1型（T1）和2型（T2）糖尿病（DM）的高血糖症和其他心血管危险因素控制的改善与动脉粥样硬化性心血管疾病（ASCVD）的同时下降和死亡相关，但死亡和死亡的负担与匹配的非DM人群相比，ASCVD的住院率仍然高出约2倍。生活方式干预（例如体育锻炼和健康饮食）以及药物（例如他汀类药物和低剂量阿司匹林）可能通过靶向导致加速动脉粥样硬化及其血栓并发症的一种或多种途径而产生有益效果。在过去三年中，随着三项大型随机，安慰剂对照，阿司匹林的发布，关于初级心血管预防与阿司匹林的获益风险平衡的争论特别激烈。从健康的老年人到DM受试者的不同环境中的初级预防试验。这篇综述的目的是在目前的一级心血管预防的多因素方法的背景下，讨论支持在糖尿病中适当使用小剂量阿司匹林的病理生理，药理和临床证据。