We conducted a new user cohort between 2001 and 2012 for primary prevention of cardiovascular disease in diabetes patients aged over 20 years from the Taiwan Longitudinal Cohort of Diabetes Patients (LCDP). Based on 2018 Standards of Medical Care in Diabetes, we recruited high-risk patients. Diabetes patients at high risk of cardiovascular disease taking aspirin within one year of risk identification were assigned to the study group. We randomly selected four aspirin non-user as comparison cohort by propensity score matching. We used time-dependent Cox-regression to estimate the outcome for primary prevention, with aspirin allocation time as a time-varying variable.

Aspirin might provide benefits for diabetes patients who have no prior cardiovascular events but have a high cardiovascular risk. Future research on more detailed and precise risk stratification will help clinicians decide who should take aspirin.