How do I assess the need for treatment with antiplatelet drugs?
• Prescribe an antiplatelet drug to all people who have pre-existing cardiovascular disease (such as a previous myocardial infarction, transient ischaemic attack or stroke, angina, or peripheral vascular disease). • For people with diabetes who do not have pre-existing cardiovascular disease, consider prescribing an antiplatelet drug (off-label use) if they are: • Fifty years of age or older. • Less than 50 years of age, but have other significant cardiovascular risk factors, including: • Features of metabolic syndrome. • Strong early family history of cardiovascular disease. • Smoking. • Hypertension. • Microalbuminuria. • Discuss the benefits and risks of antiplatelet treatment for primary prevention with the person before prescribing. • The rate of cardiovascular events in people at high risk of cardiovascular disease is lower than in people with existing cardiovascular disease. • In people who are also at high risk of gastrointestinal adverse effects from antiplatelet treatment, th