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[Acetylsalicylic acid and diabetes mellitus].

The physiopathologic mechanisms underlying cardiovascular disease in diabetic patients are briefly reviewed. The use of inhibitors of platelet aggregation is discussed as being potentially valuable in the pharmacological prevention of this condition. Acetylsalisylic acid turns out to be the reference within the repertoire of currently available drugs since it has been extensively tested in clinical trials. We conclude by discussing the recommendations of the American Diabetes Association (ADA) concerning the primary and secondary prevention of cardiovascular disease in diabetes mellitus.

Aspirin↗
PubMed2002

Inhibitory effects of sodium salicylate and acetylsalicylic acid on UVB-induced mouse skin carcinogenesis.

We conducted an in vivo carcinogenesis experiment to determine the efficacy of topical aspirin and sodium salicylate (NAS) in preventing UVB-induced nonmelanoma skin cancer. Hairless SKH-1 mice were randomly divided into eight treatment groups. They were treated topically with either 40 or 10 micromol aspirin or NAS three times weekly before 9 kJ/m(2) UVB irradiation. The experiment was carried out over 25 weeks. Both dose levels of NAS significantly inhibited (P < 0.05) the rate of tumor formation when compared with vehicle control. The 40 micromol dose of aspirin significantly inhibited the rate of tumor formation (P < 0.05), whereas the 10 micromol dose had no inhibitory effect when compared with the vehicle control. To investigate the mechanism of this inhibition, we studied UVB-induced thymine dimer formation in the epidermis of the mouse skin. We found that NAS inhibited UVB-induced thymine dimer formation (P = 0.0001), whereas aspirin did not. Therefore, we conclude that NAS prevents UVB-induced tumor growth and formation through a sunscreen effect; whereas, the moderate inhibition of aspirin may be because of a molecular event, such as the inhibition of various UVB signaling pathways.

Administration, Topical↗
PubMed2003

[Choice of antithrombotic therapy in atrial fibrillation, a daily challenge. No convincing evidence that warfarin is better than acetylsalicylic acid].

Current guidelines relating to the primary prevention of stroke in non-valvular atrial fibrillation are primarily based on randomised trials comparing warfarin with placebo. Warfarin is recommended in the majority of patients. However, weaknesses in the design and performance of these trials tend to overestimate the treatment effect. Furthermore, the inclusion of highly selected patients with a low percentage of elderly subjects, low bleeding risk, short follow-up periods and high discontinuation rates makes it impossible to generalize the results and apply them to general practice. Trials directly comparing warfarin with aspirin are the most reliable when it comes to comparing treatment efficacy. These trials have included a similar number of patients but a larger percentage of elderly patients and they comprise more years of observation and end-point events compared with the placebo-controlled warfarin trials. The results show that warfarin is not convincingly superior to aspirin in terms of stroke prevention. Warfarin can only be recommended in patients with a high risk of thromboembolic events.

Anticoagulants↗