Comparative effect of aspirin versus clopidogrel monotherapy on incident type 2 diabetes in patients with atherosclerotic cardiovascular diseases: A target trial emulation study
Main finding · Incident diabetesResult — go to the resultHazard ratio 1.02 95 % CI 0.96–1.07Authors' conclusion
Aspirin and clopidogrel have similar risks of incident diabetes, cardiovascular events, and bleeding events among patients with ASCVD. The choice between these agents may thus be influenced more by factors like cost, patient preference, or tolerance than by clinical outcomes alone.
Study context
- Population
- Adults with an incident first ASCVD event who initiated low-dose aspirin or clopidogrel between 2004 and 2021, IQVIA Medical Research Data UK primary care database
- Participants
- 111,292 adults
- Exposure
- Low-dose aspirin vs clopidogrel monotherapy
- Aspirinn = 78,012
- Clopidogreln = 33,280reference
- Outcome
- Incident T2D
Methodological detailsoverlap weighting, pooled logistic regression, UK primary care database
- Overlap weighting
- Pooled logistic regression
- UK primary care database
Main finding
Incident diabetes
Hazard ratio
1.02
95 % CI 0.96–1.07
Aspirinvs Clopidogrel
HR 1.02 (95 % CI 0.96–1.07)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR | |
|---|---|---|
| Incident diabetes, per-protocol analysisPer-protocol analysis · per-protocol | 1.06 (CI 0.97–1.15) | |
| Cardiovascular eventsAspirinvs ClopidogrelIntention-to-treat analysis | 1.00 (95 % CI 0.95–1.05) | |
| Cardiovascular eventsAspirinvs ClopidogrelPer-protocol analysis | 0.96 (95 % CI 0.89–1.03) | |
| 0.512Hazard ratio (log scale) |
Safety
| Outcome | HR (95 % CI) | |
|---|---|---|
| Bleeding eventsAspirinvs ClopidogrelIntention-to-treat analysis | 1.02 (0.97–1.08) | |
| Bleeding eventsAspirinvs ClopidogrelPer-protocol analysis | 1.01 (0.92–1.10) | |
| 0.512Hazard ratio (log scale) |
Original publication
Comparative effect of aspirin versus clopidogrel monotherapy on incident type 2 diabetes in patients with atherosclerotic cardiovascular diseases: A target trial emulation study. Diabetes Res Clin Pract. Published 8 March 2025. doi:10.
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