Introduction
Cardiovascular disease (CVD) is one of the primary causes of mortality in people with diabetes, accounting for >70% of deaths in these people.1 Low-dose aspirin is considered the most widely used agent for preventing cardiovascular disease.2-4, and its use in subjects with diabetes is also recommended by various guidelines 5–6. Several primary prevention aspirin trials, mostly done before 2000, suggested a reduction in myocardial infarction and stroke, although not mortality7 but at the cost of increased bleeding events.8–10 However, the role of Aspirin in the primary prevention of CVD is still unclear and under debate. According to guidelines by the American Diabetes Association, the American Heart Association, and the American College of Cardiology Foundation advocate using low-dose Aspirin for the primary prevention of CVD in adults with diabetes, but which should be based on the individual risk of CVD and risk of bleeding11. Aim: The present meta-analysis was done to rule out the role of Aspirin in patients with diabetes and to compare the effectiveness of Aspirin with a placebo (or no treatment) for the primary prevention of CVD and all-cause mortality events in people with diabetes.