Episode 65: A clot, a clot, I want it not - primary prevention with antiplatelets

The American Diabetes Association, American Heart Association, and American College of Cardiology Foundation have published a new "Scientific Statement " on the use of aspirin for primary cardiovascular prevention in diabetics:
Pignone M, et al. Aspirin for Primary Prevention of Cardiovascular Events in People With Diabetes. A Position Statement of the American Diabetes Association, a Scientific Statement of the American Heart Association, and an Expert Consensus Document of the American College of Cardiology Foundation. Circulation. 2010 May 27. [Epub ahead of print]
As James keeps telling us, one should really read the results and not the conclusions. The authors do a meta-analysis of the existing trials, that shows only a trend towards reduced risk, without statistical significance. They argue that, since this trend exists and aspirin has been shown to be effective in higher risk patients, the lack of statistical significance is only because not enough patients have been included in primary prevention trials, and call for further trials (we have seen this with statins). They also recommend using aspirin for primary prevention in any diabetic who has a cardiovascular risk above 10% (although at the end of the paper the authors mention that this risk assessment should take in consideration whether or not the patient is already on other drugs that lower cardiovascular risk).
I understand that these associations want to do the best for diabetic patients, but issuing guidelines based on trends without statistical significance seems a lot of wishful thinking...