SHOULD ALL ADULT DIABETICS TAKE ASPIRIN FOR PRIMARY PREVENTION OF CAD?

Aspirin is a thromboxane synthetase inhibitor. It is a drug that has been used since the 18th century, initially for fever relief, then pain relief and now for fever relief, pain relief and prevention of heart disease ( CAD ). This last indication involves " low dose " aspirin. ( And what is low-dose, is another controversy ).It does seem that there is some evidence to show that aspirin reduces MACE events, in primary prevention. This evidence is there but weak. aspirin in the secondary prevention of CAD events is strong. I remember that when I was doing my membership exams, and that was in 1978, we were asked if there is enough evidence for us to recommend that a small dose of aspirin be put into household drinking water supply, in our attempt to fight CAD? Of course our argument then ( as now ) is that there is insufficient evidence, and that aspirin does have side-effects, most notably GIT upset including hemorrahge.
Diabetes mellitus is a very common endocrine disease, that kills via its cardiac and vascular complications. In fact, cardiologist have always seen that diabetes is actually a cardiovascular disease, and a CAD equivalent.
Well, the October 16th on-line issue of BMJ, published a study by Dr Jill Belch of University of Dundee, which showed that aspirin and anti-oxidants, given to diabetics, did not reduce the incidence of CAD, in diabetics.
This study findings will further strengthen the view that aspirin should be used only for secondary CAD prevention and not for primary CAD prevention, and also, that it does not help diabetics. The same goes for anti-oxidants. At least that is what the Dundee study says.
Another age old believe bites the dust.