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Latest & greatest articles for aspirin
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Acetylsalicylic acid (ASA) more commonly known as aspirin is a painkiller that has a wide range of uses. It is frequently used to treat fever, mild pain, tooth aches, headaches and muscle aches. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) and can be used in the management of conditions such as heart attack, arthritis, blood clots and stroke. Aspirin, has been used for thousands of years, initially extracted from the leaves of willow trees.
Aspirin works in much the same way as other NSAIDs but has additional properties, such as antiplatelet activity which can make it additionally useful. More recently aspirin has been linked with cancer prevention. But the potential benefits of aspirin need to be weighed against the potential side effects, which includes gastrointestinal bleeding and Reye’s syndrome. It should be noted that aspirin should not be used in people who are allergic to drugs such as ibuprofen or a more generalized intolerance to NSAIDs. It should also be used cautiously in asthmatics and/or those with bronchospasm associated with NSAID use.
Research evidence, clinical trials and guidelines on Aspirin
A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. Experimental studies in animals and observational studies in humans suggest that regular aspirin use may decrease the risk of colorectal adenomas, the precursors to most colorectal cancers.We conducted a randomized, double-blind trial to determine the effect of aspirin on the incidence of colorectal adenomas. We randomly assigned 635 patients with previous colorectal cancer to receive (...) either 325 mg of aspirin per day or placebo. We determined the proportion of patients with adenomas, the number of recurrent adenomas, and the time to the development of adenoma between randomization and subsequent colonoscopic examinations. Relative risks were adjusted for age, sex, cancer stage, the number of colonoscopic examinations, and the time to a first colonoscopy. The study was terminated early by an independent data and safety monitoring board when statistically significant results were
A randomized trial of aspirin to prevent colorectal adenomas. Laboratory and epidemiologic data suggest that aspirin has an antineoplastic effect in the large bowel.We performed a randomized, double-blind trial of aspirin as a chemopreventive agent against colorectal adenomas. We randomly assigned 1121 patients with a recent history of histologically documented adenomas to receive placebo (372 patients), 81 mg of aspirin (377 patients), or 325 mg of aspirin (372 patients) daily. According (...) after randomization in 1084 patients (97 percent). The incidence of one or more adenomas was 47 percent in the placebo group, 38 percent in the group given 81 mg of aspirin per day, and 45 percent in the group given 325 mg of aspirin per day (global P=0.04). Unadjusted relative risks of any adenoma (as compared with the placebo group) were 0.81 in the 81-mg group (95 percent confidence interval, 0.69 to 0.96) and 0.96 in the 325-mg group (95 percent confidence interval, 0.81 to 1.13). For advanced
Aspirin and ticlopidine for prevention of recurrent stroke in black patients: a randomized trial. Blacks are disproportionately affected by stroke, and they are about 2 times more likely than most other individuals in the United States to die of or experience stroke.To determine the efficacy and safety of aspirin and ticlopidine to prevent recurrent stroke in black patients.Randomized, double-blind, investigator-initiated, multicenter trial of 1809 black men and women who recently had (...) was halted after about 6.5 years when futility analyses revealed a less than 1% probability of ticlopidine being shown superior to aspirin in the prevention of the primary outcome end point. The primary outcome of recurrent stroke, myocardial infarction, or vascular death was reached by 133 (14.7%) of 902 patients assigned to ticlopidine and 112 (12.3%) of 907 patients assigned to aspirin (hazard ratio, 1.22; 95% confidence interval, 0.94-1.57). Kaplan-Meier curves for time to event for the primary
An update on aspirin in the primary prevention of cardiovascular disease Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Effects of aspirin consumption during pregnancy on pregnancy outcomes: meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Leukotriene-receptor expression on nasal mucosal inflammatory cells in aspirin-sensitive rhinosinusitis. Patients with asthma who have aspirin sensitivity have greater cysteinyl leukotriene production and greater airway hyperresponsiveness to the effects of inhaled cysteinyl leukotrienes than their aspirin-tolerant counterparts. We hypothesized that the latter effect reflects elevated expression of the cysteinyl leukotriene receptor CysLT1 on inflammatory cells in the target organ and that its (...) expression is down-regulated by aspirin desensitization.We obtained nasal-biopsy specimens from 22 aspirin-sensitive and 12 non-aspirin-sensitive patients with chronic rhinosinusitis and nasal polyps. Additional specimens were then obtained from subgroups of the aspirin-sensitive patients after intranasal application of lysine aspirin or placebo for two weeks (five and four patients, respectively) or for six months (five and four patients, respectively). The numbers of leukocytes expressing the CysLT1
Aspirin and mortality from coronary bypass surgery. There is no therapy known to reduce the risk of complications or death after coronary bypass surgery. Because platelet activation constitutes a pivotal mechanism for injury in patients with atherosclerosis, we assessed whether early treatment with aspirin could improve survival after coronary bypass surgery.At 70 centers in 17 countries, we prospectively studied 5065 patients undergoing coronary bypass surgery, of whom 5022 survived the first (...) 48 hours after surgery. We gathered data on 7500 variables per patient and adjudicated outcomes centrally. The primary focus was to discern the relation between early aspirin use and fatal and nonfatal outcomes.During hospitalization, 164 patients died (3.2 percent), and 812 others (16.0 percent) had nonfatal cardiac, cerebral, renal, or gastrointestinal ischemic complications. Among patients who received aspirin (up to 650 mg) within 48 hours after revascularization, subsequent mortality was 1.3
Cost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart disease. Both aspirin and clopidogrel reduce the rate of cardiovascular events in patients with coronary heart disease. We estimated the cost effectiveness of the increased use of aspirin, clopidogrel, or both for secondary prevention in patients with coronary heart disease.We used the Coronary Heart Disease Policy Model, a computer simulation of the U.S. population, to estimate the incremental cost (...) effectiveness (in dollars per quality-adjusted years of life gained) of four strategies in patients over 35 years of age with coronary disease from 2003 to 2027: aspirin for all eligible patients (i.e., those who were not allergic to or intolerant of aspirin), aspirin for all eligible patients plus clopidogrel for patients who were ineligible for aspirin, clopidogrel for all patients, and the combination of aspirin for all eligible patients plus clopidogrel for all patients.The extension of aspirin therapy
Aspirin for the primary prevention of cardiovascular events: recommendation and rationale. This statement summarizes the recommendation of the third U.S. Preventive Services Task Force (USPSTF) for aspirin for the primary prevention of cardiovascular events, as well as the supporting scientific evidence. The complete information on which this statement is based, including evidence tables and references, can be found in a companion article in this issue. Copies of this document, the summary
Effects of long-term treatment with angiotensin-converting-enzyme inhibitors in the presence or absence of aspirin: a systematic review. Results from a retrospective analysis of the Studies of Left Ventricular Dysfunction (SOLVD) study suggest that angiotensin-converting-enzyme (ACE) inhibitors may be less effective in patients receiving aspirin. We aimed to confirm or refute this theory.We used the Peto-Yusuf method to undertake a systematic overview of data for 22060 patients from six long (...) -term randomised trials of ACE inhibitors to assess whether aspirin altered the effects of ACE inhibitor therapy on major clinical outcomes (composite of death, myocardial infarction, stroke, hospital admission for congestive heart failure, or revascularisation).Baseline characteristics, and prognosis in patients allocated placebo, differed strikingly between those who were and were not taking aspirin at baseline. Results from analyses of all trials, except SOLVD, did not suggest any significant
Oral anticoagulants vs aspirin in nonvalvular atrial fibrillation: an individual patient meta-analysis. Patients with nonvalvular atrial fibrillation (AF) have an increased risk of stroke and other vascular events.To compare the risk of vascular and bleeding events in patients with nonvalvular AF treated with vitamin K -inhibiting oral anticoagulants or acetylsalicylic acid (aspirin).Pooled analysis of patient-level data from 6 published, randomized clinical trials.A total of 4052 patients (...) with AF randomly assigned to receive therapeutic doses of oral anticoagulant or aspirin with or without low-dose oral anticoagulants.Ischemic and hemorrhagic stroke, other cardiovascular events, all-cause death, and major bleeding events. Person-year incidence rates were calculated to provide crude comparisons. Relative efficacy was assessed using proportional hazards modeling stratified by study. The variation of the oral anticoagulant's relative effect by pertinent patient factors was explored
Summary of the evidence: aspirin for the primary prevention of cardiovascular events Summary of the evidence: aspirin for the primary prevention of cardiovascular events Summary of the evidence: aspirin for the primary prevention of cardiovascular events Hayden M, Pignone M, Phillips C, Mulrow C Authors' objectives To examine the benefits and harms of aspirin for the primary prevention of cardiovascular events in patients without a previous history of cardiovascular disease (CVD). Searching (...) in the trials ranged from 3.6 to 6.8 years. Specific interventions included in the review Studies that compared aspirin with placebo or no aspirin were eligible for inclusion. The included trials used aspirin at a dose of between 75 and 500 mg/day. Four of the included studies also gave participants additional therapies: one study gave beta-carotene to 50% of the participants, one study gave warfarin to its participants, one study gave felodipine with or without an angiotensin-converting enzyme inhibitor
Evaluation of the benefits and risks of low-dose aspirin in the secondary prevention of cardiovascular and cerebrovascular events Evaluation of the benefits and risks of low-dose aspirin in the secondary prevention of cardiovascular and cerebrovascular events Evaluation of the benefits and risks of low-dose aspirin in the secondary prevention of cardiovascular and cerebrovascular events Weisman S M, Graham D Y Authors' objectives To compare the benefit and gastrointestinal risk of low-dose (...) aspirin for the secondary prevention of thromboembolic events. Searching MEDLINE, EMBASE, and Excerpta Medica were searched for reports published after 1970 on aspirin for secondary prevention indications, which have been approved by the U.S. Food and Drug Administration (FDA). These indications are summarised in the FDA's 1998 rule and updated professional labelling for aspirin. Study selection Study designs of evaluations included in the review Randomised, placebo-controlled trials were eligible
Effects of long-term treatment with angiotensin-converting-enzyme inhibitors in the presence or absence of aspirin: a systematic review Effects of long-term treatment with angiotensin-converting-enzyme inhibitors in the presence or absence of aspirin: a systematic review Effects of long-term treatment with angiotensin-converting-enzyme inhibitors in the presence or absence of aspirin: a systematic review Teo K K, Yusuf S, Pfeffer M, Kober L, Hall A, Pogue J, Latini R, Collins R Authors (...) ' objectives To confirm or refute the theory that aspirin alters the effects of angiotensin-converting enzyme (ACE) inhibitor therapy on major clinical outcomes, by conducting a meta-analysis of individual patient data (IPD) from trials in which the patients were randomised to receive ACE inhibitors or placebo, and either took or did not take aspirin at baseline. Searching MEDLINE was searched, although the dates over which the search was conducted were not given. In addition, researchers and colleagues
Aspirin for the primary prevention of cardiovascular events Aspirin for the primary prevention of cardiovascular events Aspirin for the primary prevention of cardiovascular events Hayden M, Pignone M, Phillips C, Mulrow C Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Hayden M, Pignone M, Phillips C, Mulrow C. Aspirin for the primary (...) prevention of cardiovascular events. Rockville: Agency for Healthcare Research and Quality (AHRQ). Preventive Services Task Force Systematic Evidence Review. 2002 Authors' objectives To examine the benefits and harms of aspirin chemoprevention. Authors' conclusions Aspirin can prevent myocardial infarctions but increases the risk of gastrointestinal bleeding and appears to increase the risk of hemorrhagic stroke. The net benefit of aspirin increases with increasing cardiovascular risk. The decision about
Aspirin consumption during the first trimester of pregnancy and congenital anomalies: a meta-analysis Aspirin consumption during the first trimester of pregnancy and congenital anomalies: a meta-analysis Aspirin consumption during the first trimester of pregnancy and congenital anomalies: a meta-analysis Kozer E, Nikfar S, Costei A, Boskovic R, Nulman I, Koren G Authors' objectives To determine whether aspirin use during the first trimester of pregnancy is associated with an increased risk (...) . Study selection Study designs of evaluations included in the review Prospective and retrospective controlled studies were eligible for inclusion. Uncontrolled studies, case reports or case series of less than six patients, editorials and reviews were excluded. Specific interventions included in the review Studies of aspirin were eligible for inclusion. The included studies obtained information on aspirin exposure mainly from interviews with mothers; the timing of these ranged from during early
Aspirin in diabetic retinopathy: a systematic review Aspirin in diabetic retinopathy: a systematic review Aspirin in diabetic retinopathy: a systematic review Bergerhoff K, Clar C, Richter B Authors' objectives To assess the impact of aspirin alone and in combination with other antiplatelet agents on the progression of diabetic retinopathy. Searching The Cochrane Library (including the Cochrane Controlled Trials Register) and MEDLINE were searched up to 2001. Study selection Study designs (...) of evaluations included in the review Only randomised controlled trials (RCTs) were eligible for inclusion. Specific interventions included in the review Studies of aspirin alone versus placebo, or aspirin in combination with dipyridamole versus placebo, were eligible for inclusion. Aspirin alone was used in two of the included studies, while in one study aspirin alone was compared with aspirin-dipyridamole. The aspirin dosage ranged from 650 to 990 mg/day; the dipyridamole dosage was 225 mg/day. All
Aspirin prophylaxis in patients at low risk for cardiovascular disease: a systematic review of all-cause mortality Aspirin prophylaxis in patients at low risk for cardiovascular disease: a systematic review of all-cause mortality Aspirin prophylaxis in patients at low risk for cardiovascular disease: a systematic review of all-cause mortality Boltri J M, Akerson M R, Vogel R L Authors' objectives To assess whether aspirin reduces all-cause mortality in low-risk patients. Searching MEDLINE (...) and the Cochrane Library were searched using the terms 'aspirin' or 'antiplatelet therapy' and 'primary prevention' or 'prevention' and 'primary' and 'mortality'. Additional searches were made with 'primary prevention' and 'myocardial infarction' or 'stroke'. No search dates were reported. The Internet was also searched using the same search terms. The authors did not state whether any language restrictions were applied. Study selection Study designs of evaluations included in the review Randomised controlled
Chemoprevention of colorectal cancer by aspirin: a cost-effectiveness analysis Chemoprevention of colorectal cancer by aspirin: a cost-effectiveness analysis Chemoprevention of colorectal cancer by aspirin: a cost-effectiveness analysis Suleiman S, Rex D K, Sonnenberg A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed (...) critical assessment on the reliability of the study and the conclusions drawn. Health technology Three strategies for the prevention of colorectal cancer (CRC) were examined: colonoscopy (COL) once every 10 years or, in case of adenomatous polyps, every 3 years until polyps were no longer found; chemoprevention (CHE) with 325 mg/day aspirin; and a combination of the first and second strategies (i.e. COL every 10 or 3 years plus 325 mg/day aspirin). Type of intervention Diagnosis and primary prevention
Cost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart disease Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.