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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
Lansoprazole for the prevention of recurrences of ulcer complications from long-term low-dose aspirin use. The role of gastric acid suppression in preventing the recurrence of ulcer complications after the eradication of Helicobacter pylori infection in patients taking long-term low-dose aspirin is uncertain.We enrolled 123 patients who had ulcer complications after using low-dose aspirin continuously for more than one month and who had H. pylori infection. After the ulcers had healed and the H (...) . pylori infection was eradicated, the patients were randomly assigned to treatment with 30 mg of lansoprazole daily or placebo, in addition to 100 mg of aspirin daily, for 12 months. The primary end point was the recurrence of ulcer complications.During a median follow-up of 12 months, 9 of the 61 patients in the placebo group (14.8 percent), as compared with 1 of the 62 patients in the lansoprazole group (1.6 percent), had a recurrence of ulcer complications (adjusted hazard ratio, 9.6; 95 percent
Aspirin and coumadin after acute coronary syndromes (the ASPECT-2 study): a randomised controlled trial. Antiplatelet treatment with aspirin and oral anticoagulants reduces recurrence of ischaemic events after myocardial infarction. We aimed to investigate which of these drugs is more effective in the long term after acute coronary events, and whether the combination of aspirin and oral anticoagulants offers greater benefit than either of these agents alone, without excessive risk (...) of bleeding.In a randomised open-label trial in 53 sites, we randomly assigned 999 patients to low-dose aspirin, high-intensity oral anticoagulation, or combined low-dose aspirin and moderate intensity oral anticoagulation. Patients were followed up for a maximum of 26 months. The primary composite endpoint was first occurrence of myocardial infarction, stroke, or death.The primary endpoint was reached in 31 (9%) of 336 patients on aspirin, in 17 (5%) of 325 on anticoagulants (hazard ratio 0.55 [95% CI 0.30
2002LancetControlled trial quality: predicted high
Warfarin, aspirin, or both after myocardial infarction. The role of antithrombotic therapy in secondary prevention after myocardial infarction is well established. Although the available literature suggests that warfarin is superior to aspirin, aspirin is currently the more widely used drug. We studied the efficacy and safety of warfarin, aspirin, or both after myocardial infarction.In a randomized, multicenter trial in 3630 patients, 1216 received warfarin (in a dose intended to achieve (...) an international normalized ratio [INR] of 2.8 to 4.2), 1206 received aspirin (160 mg daily), and 1208 received aspirin (75 mg daily) combined with warfarin (in a dose intended to achieve an INR of 2.0 to 2.5). The mean duration of observation was four years.The primary outcome, a composite of death, nonfatal reinfarction, or thromboembolic cerebral stroke, occurred in 241 of 1206 patients receiving aspirin (20.0 percent), 203 of 1216 receiving warfarin (16.7 percent; rate ratio as compared with aspirin, 0.81
Acetaminophen, aspirin, and chronic renal failure. Several epidemiologic studies have demonstrated an association between heavy consumption of nonnarcotic analgesics and the occurrence of chronic renal failure, but it is unclear which is the cause and which is the effectIn a nationwide, population-based, case-control study of early-stage chronic renal failure in Sweden, face-to-face interviews were conducted with 926 patients with newly diagnosed renal failure and 998 control subjects, of whom (...) of 2.5 in the risk of chronic renal failure from any cause. The relative risks rose with increasing cumulative lifetime doses, rose more consistently with acetaminophen use than with aspirin use, and were increased for most disease-specific types of chronic renal failure. When we disregarded the recent use of analgesics, which could have occurred in response to antecedents of renal disease, the associations were only slightly attenuatedOur results are consistent with the existence of exacerbating
Aspirin as an adjunct to screening for prevention of sporadic colorectal cancer. A cost-effectiveness analysis. Aspirin may decrease colorectal cancer incidence, but its role as an adjunct to or substitute for screening has not been evaluated.To examine the potential cost-effectiveness of aspirin chemoprophylaxis in relation to screening.Markov model.Literature on colorectal cancer epidemiology, screening, costs, and aspirin chemoprevention (1980-1999).General U.S. population.50 to 80 years (...) of age.Third-party payer.Aspirin therapy in patients screened with sigmoidoscopy every 5 years and fecal occult blood testing every year (FS/FOBT) or colonoscopy every 10 years (COLO).Discounted cost per life-year gained.When a 30% reduction in colorectal cancer risk was assumed, aspirin increased costs and decreased life-years because of related complications as an adjunct to FS/FOBT and cost $149 161 per life-year gained as an adjunct to COLO. In patients already taking aspirin, screening with FS/FOBT
Aspirin use and all-cause mortality among patients being evaluated for known or suspected coronary artery disease: A propensity analysis. Although aspirin has been shown to reduce cardiovascular morbidity and short-term mortality following acute myocardial infarction, the association between its use and long-term all-cause mortality has not been well defined.To determine whether aspirin is associated with a mortality benefit in stable patients with known or suspected coronary disease (...) and to identify patient characteristics that predict the maximum absolute mortality benefit from aspirin.Prospective, nonrandomized, observational cohort study conducted between 1990 and 1998 at an academic medical institution, with a median follow-up of 3.1 years.Of 6174 consecutive adults undergoing stress echocardiography for evaluation of known or suspected coronary disease, 2310 (37%) were taking aspirin. Patients with significant valvular disease or documented contraindication to aspirin use, including
Aspirin for the prevention of preeclampsia in women with abnormal uterine artery Doppler: a meta-analysis Aspirin for the prevention of preeclampsia in women with abnormal uterine artery Doppler: a meta-analysis Aspirin for the prevention of preeclampsia in women with abnormal uterine artery Doppler: a meta-analysis Coomarasamy A, Papaioannou S, Gee H, Khan K S Authors' objectives To assess the effect of aspirin in preventing pre-eclampsia in women identified as being at high risk (...) by an abnormal uterine artery Doppler examination in the second trimester. Searching MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched for trials published between 1966 and November 2000. A combination of search terms were used to generate two subsets of citations: one including studies of 'aspirin' ('aspirin', 'antiplatelet', 'salicyl', 'acetylsalicyl', and 'platelet aggregation inhibitors') and the other including studies of 'Doppler ultrasonography' ('ultrasonography', 'ultraso
Aspirin as an adjunct to screening for prevention of sporadic colorectal cancer: a cost-effectiveness analysis Aspirin as an adjunct to screening for prevention of sporadic colorectal cancer: a cost-effectiveness analysis Aspirin as an adjunct to screening for prevention of sporadic colorectal cancer: a cost-effectiveness analysis Ladabaum U, Chopra C L, Huang G, Scheiman J M, Chernew M E, Fendrick A M 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 Aspirin (a non-steroidal anti-inflammatory drug) used as prevention therapy (chemoprevention) for sporadic colorectal cancer, as an adjunct to widely used screening strategies. The screening strategies included flexible sigmoidoscopy every 5 years and yearly faecal occult blood
Association between aspirin and upper gastrointestinal complications: systematic review of epidemiologic studies Association between aspirin and upper gastrointestinal complications: systematic review of epidemiologic studies Association between aspirin and upper gastrointestinal complications: systematic review of epidemiologic studies Garcia Rodriguez L A, Hernandez-Diaz S, de Abajo F J Authors' objectives To systematically review the literature on serious upper gastrointestinal complications (...) (UGIC) associated with aspirin use, and to evaluate the influence of dose and formulation of aspirin as well as the effect of study design. Searching MEDLINE was searched from 1990 to February 2001. The search terms used were 'anti-inflammatory nonsteroidal agents' (both overall and aspirin), 'adverse effects', and 'toxicity' combined with 'peptic ulcer', 'stomach ulcer', 'duodenal ulcer', or 'gastrointestinal diseases' (including haemorrhage and perforation). The references of previous reviews were
Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen. Many patients who have had upper gastrointestinal bleeding continue to take low-dose aspirin for cardiovascular prophylaxis or other non-steroidal antiinflammatory drugs (NSAIDs) for musculoskeletal pain. It is uncertain whether infection with Helicobacter pylori is a risk factor for bleeding in such patients.We studied patients with a history of upper (...) gastrointestinal bleeding who were infected with H. pylori and who were taking low-dose aspirin or other NSAIDs. We evaluated whether eradication of the infection or omeprazole treatment was more effective in preventing recurrent bleeding. We recruited patients who presented with upper gastrointestinal bleeding that was confirmed by endoscopy. Their ulcers were healed by daily treatment with 20 mg of omeprazole for eight weeks or longer. Then, those who had been taking aspirin were given 80 mg of aspirin daily
Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomised trial in general practice. Collaborative Group of the Primary Prevention Project. In addition to the treatment of specific cardiovascular risk factors, intervention which interferes with the general mechanisms of atherosclerosis could further reduce the incidence of cardiovascular events. We aimed to investigate in general practice the efficacy of antiplatelets and antioxidants in primary prevention of cardiovascular (...) events in people with one or more major cardiovascular risk factors.We did a randomised controlled open 2x2 factorial trial to investigate low-dose aspirin (100 mg/day) and vitamin E (300 mg/day) in the prevention of cardiovascular events, in people with one or more of the following: hypertension, hypercholesterolaemia, diabetes, obesity, family history of premature myocardial infarction, or individuals who were elderly.4495 people (2583 female, mean age 64.4 years) were included in the trial. After
2001LancetControlled trial quality: predicted high
Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Despite the use of aspirin, there is still a risk of ischaemic events after percutaneous coronary intervention (PCI). We aimed to find out whether, in addition to aspirin, pretreatment with clopidogrel followed by long-term therapy after PCI is superior to a strategy of no pretreatment and short-term therapy for only 4 weeks after PCI (...) .2658 patients with non-ST-elevation acute coronary syndrome undergoing PCI in the CURE study had been randomly assigned double-blind treatment with clopidogrel (n=1313) or placebo (n=1345). Patients were pretreated with aspirin and study drug for a median of 6 days before PCI during the initial hospital admission, and for a median of 10 days overall. After PCI, most patients (>80%) in both groups received open-label thienopyridine for about 4 weeks, after which study drug was restarted for a mean
2001LancetControlled trial quality: predicted high
Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. Despite current treatments, patients who have acute coronary syndromes without ST-segment elevation have high rates of major vascular events. We evaluated the efficacy and safety of the antiplatelet agent clopidogrel when given with aspirin in such patients.We randomly assigned 12,562 patients who had presented within 24 hours after the onset of symptoms to receive clopidogrel (...) (300 mg immediately, followed by 75 mg once daily) (6259 patients) or placebo (6303 patients) in addition to aspirin for 3 to 12 months.The first primary outcome--a composite of death from cardiovascular causes, nonfatal myocardial infarction, or stroke--occurred in 9.3 percent of the patients in the clopidogrel group and 11.4 percent of the patients in the placebo group (relative risk with clopidogrel as compared with placebo, 0.80; 95 percent confidence interval, 0.72 to 0.90; P<0.001
Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. Patients with arthritis and vascular disease may receive both low-dose aspirin and other nonsteroidal antiinflammatory drugs. We therefore investigated potential interactions between aspirin and commonly prescribed arthritis therapiesWe administered the following combinations of drugs for six days: aspirin (81 mg every morning) two hours before ibuprofen (400 mg every morning) and the same medications in the reverse order (...) ; aspirin two hours before acetaminophen (1000 mg every morning) and the same medications in the reverse order; aspirin two hours before the cyclooxygenase-2 inhibitor rofecoxib (25 mg every morning) and the same medications in the reverse order; enteric-coated aspirin two hours before ibuprofen (400 mg three times a day); and enteric-coated aspirin two hours before delayed-release diclofenac (75 mg twice daily)Serum thromboxane B(2) levels (an index of cyclooxygenase-1 activity in platelets
Tinzaparin in acute ischaemic stroke (TAIST): a randomised aspirin-controlled trial. Low-molecular-weight heparins and heparinoids are superior to unfractionated heparin in the prevention and treatment of venous thromboembolism, but their safety and efficacy in acute ischaemic stroke are inadequately defined.This randomised, double-blind, aspirin-controlled trial tested the safety and efficacy of treatment with high-dose tinzaparin (175 anti-Xa IU/kg daily; 487 patients), medium-dose tinzaparin (...) (100 anti-Xa IU/kg daily; 508 patients), or aspirin (300 mg daily; 491 patients) started within 48 h of acute ischaemic stroke and given for up to 10 days. Primary intracerebral haemorrhage was excluded by computed tomography. Outcome was assessed, with treatment allocation concealed, by the modified Rankin scale at 6 months (independence [scores 0-2] vs dependence or death [scores 3-6]).Of 1486 randomised patients, two did not receive treatment and 46 were lost to follow-up. The proportions
2001LancetControlled trial quality: predicted high
A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke. Despite the use of antiplatelet agents, usually aspirin, in patients who have had an ischemic stroke, there is still a substantial rate of recurrence. Therefore, we investigated whether warfarin, which is effective and superior to aspirin in the prevention of cardiogenic embolism, would also prove superior in the prevention of recurrent ischemic stroke in patients with a prior noncardioembolic ischemic (...) stroke.In a multicenter, double-blind, randomized trial, we compared the effect of warfarin (at a dose adjusted to produce an international normalized ratio of 1.4 to 2.8) and that of aspirin (325 mg per day) on the combined primary end point of recurrent ischemic stroke or death from any cause within two years.The two randomized study groups were similar with respect to base-line risk factors. In the intention-to-treat analysis, no significant differences were found between the treatment groups in any
Aspirin for vascular dementia. For patients with a diagnosis of vascular dementia there is evidence that aspirin is widely prescribed - in one study, completed by geriatricians and psychiatrists in the UK, 80% of patients with cognitive impairment (with vascular risk factors) were prescribed aspirin. However, a number of queries remain unanswered: Is there convincing evidence that aspirin benefits patients with vascular dementia? Does aspirin affect cognition or improve prognosis? In addition (...) , does the risk of cerebral or gastric haemorrhage outweigh any benefit?To assess the evidence of effectiveness of the use of aspirin for vascular dementia.Computerized databases were searched independently by two reviewers. In addition, relevant websites were searched and some journals were handsearched. Specialists in the field were approached for unpublished material and any publications found were searched for additional references. The most recent search for trials was carried out in February
Single dose oral aspirin for acute pain. Aspirin has been known to be an effective analgesic for many years and is commonly used throughout the world for many different pain conditions. It is important for both prescribers and patients to have the best possible information about the efficacy and safety of analgesics, and this need is reflected in patient surveys which show that postoperative pain is often poorly managed. We also need to benchmark relative efficacy and safety of current (...) analgesics so that we can compare them with new analgesics.To quantitatively assess the analgesic efficacy and adverse effects of a single-dose of aspirin in acute pain of moderate to severe intensity.Randomised trials were identified by searching Medline (1966 to March 1998), Embase (1980 to January 1998), the Cochrane Library (Issue 1,1998) and the Oxford Pain Relief Database (1950 to 1994).The inclusion criteria used were: full journal publication, postoperative pain or a mixture of postoperative
Aspirin for vascular dementia. For patients with a diagnosis of vascular dementia there is evidence that aspirin is widely prescribed - in one study, completed by geriatricians and psychiatrists in the UK, 80% of patients with cognitive impairment (with vascular risk factors) were prescribed aspirin. However, a number of queries remain unanswered: Is there convincing evidence that aspirin benefits patients with vascular dementia? Does aspirin affect cognition or improve prognosis? In addition (...) , does the risk of cerebral or gastric haemorrhage outweigh any benefit? The aim of this review is to assess the evidence of effectiveness of aspirin in those with a diagnosis of vascular dementia.To assess the evidence of effectiveness of the use of aspirin for vascular dementia.Computerised databases were searched independently by two reviewers. In addition, relevant websites were searched and some journals were handsearched. Specialists in the field were approached for unpublished material
Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis. To assess the incidence of gastrointestinal haemorrhage associated with long term aspirin therapy and to determine the effect of dose reduction and formulation on the incidence of such haemorrhage.Meta-analysis of 24 randomised controlled trials (almost 66 000 participants).Aspirin compared with placebo or no treatment, for a minimum of one year.Incidence of gastrointestinal haemorrhage.Gastrointestinal (...) haemorrhage occurred in 2.47% of patients taking aspirin compared with 1.42% taking placebo (odds ratio 1.68; 95% confidence interval 1.51 to 1.88); the number needed to harm was 106 (82 to 140) based on an average of 28 months' therapy. At doses below 163 mg/day, gastrointestinal haemorrhage occurred in 2.30% of patients taking aspirin compared with 1.45% taking placebo (1.59; 1.40 to 1.81). Meta-regression showed no relation between gastrointestinal haemorrhage and dose. For modified release