Aspirin is an anti Thrombotic agent that inhibits Platelets by irreversibly acetylating the serine residue of cyclooxygenase 1 in platelets with subsequently reduced level of Prothrombotic Thromboxane A2. In patient with known cardiovascular disease the potential for Aspirin to reduce further cardiovascular events. Significantly out weight the risk of major bleeding and thus Aspirin has become a mainstay in secondary prevention of CVD. However in primary prevention it's role was dubious. This is due to an unclear balance between the risk and benifit in Aspirin treated patients without a diagnosed atherosclerotic disease. Previously published meta analysis have indicated that Aspirin significantly reduces myocardial infarction and major adverse cardiovascular events without impact on stroke and CV mortality. Moreover an increased risk of major bleeding events with Aspirin strongly out weight the benifits of Aspirin Treatment in primary prevention. As a result current consensus ECG guideline does not recommend routine Aspirin Treatment without high CV risk. Similarly use of pharmacological lipid lowering intervention in individual with hypercholesterolemia and known cardiovascular disease is well established. Currently European society of cardiology guidelines recommended immediate initiation of drugs in adjunct to lifestyle intervention in these patients with high cardiovascular risk. In these clinical setting Statins are generally chosen as the first choice drug intervention in consideration of the robust evidence showing a reduction in all causes of mortality and major adverse cardiac events. In contrast primary prevention with only statin even in subset of patients with high risk of cardiovascular events are not A well established. In our study we uses combination of low dose Aspirin and Atorvastatin in primary prevention of cardiovascular risk in diabetic patients in a Tribal based population.
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