Latest & greatest articles for aspirin

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Aspirin

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

The Trip Database has an extensive collection of articles on aspirin ranging from clinical trials, systematic reviews, clinical guidelines and case reports. These can be found via searching the site.

Top results for aspirin

501. ISIS-2: 10 year survival among patients with suspected acute myocardial infarction in randomised comparison of intravenous streptokinase, oral aspirin, both, or neither. The ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. (PubMed)

ISIS-2: 10 year survival among patients with suspected acute myocardial infarction in randomised comparison of intravenous streptokinase, oral aspirin, both, or neither. The ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. To assess effects of intravenous streptokinase, one month of oral aspirin, or both, on long term survival after suspected acute myocardial infarction.Randomised, "2 x 2 factorial," placebo controlled trial.417 hospitals in 16 countries.17 187 (...) patients with suspected acute myocardial infarction randomised between March 1985 and December 1987. Follow up of vital status complete to at least 1 January 1990 for 95% of all patients and to mid-1997 for the 6213 patients in United Kingdom.Intravenous streptokinase (1.5 MU in 1 hour) and oral aspirin (162 mg daily for 1 month) versus matching placebos.Mortality from all causes during up to 10 years' follow up, with subgroup analyses based on 4 year follow up.After randomisation, 1841 deaths were

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1998 BMJ Controlled trial quality: predicted high

502. Low-dose aspirin to prevent preeclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. (PubMed)

Low-dose aspirin to prevent preeclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Whether low-dose aspirin prevents preeclampsia is unclear. It is not recommended as prophylaxis in women at low risk for preeclampsia but may reduce the incidence of the disease in women at high risk.We conducted a double-blind, randomized, placebo-controlled trial in four groups of pregnant women at high risk for preeclampsia (...) , including 471 women with pregestational insulin-treated diabetes mellitus, 774 women with chronic hypertension, 688 women with multifetal gestations, and 606 women who had had preeclampsia during a previous pregnancy. The women were enrolled between gestational weeks 13 and 26 and received either 60 mg of aspirin or placebo daily.Outcome data were obtained on all but 36 of the 2539 women who entered the study. The incidence of preeclampsia was similar in the 1254 women in the aspirin group and the 1249

1998 NEJM Controlled trial quality: predicted high

503. A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina. Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Study Investigators. (PubMed)

A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina. Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Study Investigators. Activation of platelets is central to the pathophysiology of unstable angina. We studied whether inhibition of the final common pathway for platelet aggregation with tirofiban, a nonpeptide glycoprotein IIb/IIIa receptor antagonist, would improve clinical outcome in this condition.In a double-blind study, we randomly (...) assigned 3232 patients who were already receiving aspirin to additional treatment with intravenous tirofiban for 48 hours. The primary end point was a composite of death, myocardial infarction, or refractory ischemia at 48 hours.The incidence of the composite end point was 32 percent lower at 48 hours in the group that received tirofiban (3.8 percent, vs. 5.6 percent with heparin; risk ratio, 0.67; 95 percent confidence interval, 0.48 to 0.92; P=0.01). Percutaneous revascularization was performed

1998 NEJM Controlled trial quality: predicted high

504. Aspirin in the primary prevention of cardiovascular disease and colon cancer

Aspirin in the primary prevention of cardiovascular disease and colon cancer Aspirin in the primary prevention of cardiovascular disease and colon cancer Aspirin in the primary prevention of cardiovascular disease and colon cancer Hailey D, Harstall 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 Hailey D, Harstall C. Aspirin (...) cancer. ASA prophylaxis is effective in various groups who are at high risk for cardiovascular disease. However, more effective treatments are available for some conditions, such as atrial fibrillation, which are associated with a high risk of stroke, though such treatments are associated with a higher risk of complications. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Aspirin /therapeutic use; Cerebrovascular Disorders; Colorectal Neoplasms; Myocardial Infarction

1997 Health Technology Assessment (HTA) Database.

505. Combined aspirin and metoclopramide in the acute treatment of migraine attacks: a review

Combined aspirin and metoclopramide in the acute treatment of migraine attacks: a review Combined aspirin and metoclopramide in the acute treatment of migraine attacks: a review Combined aspirin and metoclopramide in the acute treatment of migraine attacks: a review Chabriat H, Danchot J, Hugues F C, Joire J E Authors' objectives To review all the trials evaluating the efficacy of combined aspirin and metoclopramide (CAM) in the acute treatment of migraine attacks. Searching MEDLINE (...) and Excerpta Medica were searched from 1975 to 1996. No search terms were provided. Study selection Study designs of evaluations included in the review Both open and double-blind trials were included in the review. No details were provided of the method used to allocate the patients to the groups. Uncontrolled studies were also included. Specific interventions included in the review The combination of oral aspirin (in doses ranging from 650 to 900 mg) and oral metoclopramide (10 mg per dose) was compared

1997 DARE.

506. A meta-analysis of low dose aspirin for the prevention of intrauterine growth retardation

A meta-analysis of low dose aspirin for the prevention of intrauterine growth retardation A meta-analysis of low dose aspirin for the prevention of intrauterine growth retardation A meta-analysis of low dose aspirin for the prevention of intrauterine growth retardation Leitich H, Egarter C, Husslein P, Kaider A, Schemper M Authors' objectives To determine more precisely the effect of prophylactic low-dose aspirin on intra-uterine growth retardation and perinatal mortality. Searching Eighteen (...) medical databases including MEDLINE (from 1964 onwards) and EMBASE (from 1974 onwards) were searched using the terms 'acetylsalicylic acid', 'aspirin', 'pregnancy', 'randomised' and 'meta-analysis'. References from retrieved reports and review articles were also examined. Only reports published in the English language were considered. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) of aspirin alone or in combination with another antiplatelet

1997 DARE.

507. Do codeine and caffeine enhance the analgesic effect of aspirin: a systematic overview

Do codeine and caffeine enhance the analgesic effect of aspirin: a systematic overview Do codeine and caffeine enhance the analgesic effect of aspirin: a systematic overview Do codeine and caffeine enhance the analgesic effect of aspirin: a systematic overview Zhang W Y, Li Wan Po A Authors' objectives To assess whether codeine and caffeine enhance the analgesic effect of aspirin in post-operative pain. Searching Computerised searches of MEDLINE and BIDS (EMBASE and ISI databases) were (...) were included. The observation period in the trials ranged from 2 to 12 hours. Studies were excluded on the basis of the following: relevant data were not extractable; there was self-controlled dose adjustment; syrup or buffered formulations were used; or the report of the trial was unobtainable. Abstracts and reports from multi-dose trials were also excluded. Specific interventions included in the review Oral formulations of aspirin, aspirin and codeine, aspirin and caffeine, and placebo

1997 DARE.

508. Randomised controlled trial of aspirin and aspirin plus heparin in pregnant women with recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies) (PubMed)

Randomised controlled trial of aspirin and aspirin plus heparin in pregnant women with recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies) To determine whether treatment with low dose aspirin and heparin leads to a higher rate of live births than that achieved with low dose aspirin alone in women with a history of recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies), lupus anticoagulant, and cardiolipin (...) antibodies (or anticardiolipin antibodies).Randomised controlled trial.Specialist clinic for recurrent miscarriages.90 women (median age 33 (range 22-43)) with a history of recurrent miscarriage (median number 4 (range 3-15)) and persistently positive results for phospholipid antibodies.Either low dose aspirin (75 mg daily) or low dose aspirin and 5000 U of unfractionated heparin subcutaneously 12 hourly. All women started treatment with low dose aspirin when they had a positive urine pregnancy test

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1997 BMJ Controlled trial quality: predicted high

509. Randomised double-blind trial of fixed low-dose warfarin with aspirin after myocardial infarction. Coumadin Aspirin Reinfarction Study (CARS) Investigators. (PubMed)

Randomised double-blind trial of fixed low-dose warfarin with aspirin after myocardial infarction. Coumadin Aspirin Reinfarction Study (CARS) Investigators. Antiplatelet therapy with aspirin and systematic anticoagulation with warfarin reduce cardiovascular morbidity and mortality after myocardial infarction when given alone. In the Coumadin Aspirin Reinfarction Study (CARS), we aimed to find out whether a combination of low-dose warfarin and low-dose aspirin would give superior results (...) to standard aspirin monotherapy without excessive bleeding risk.We used a randomised double-blind study design. At 293 sites, we randomly assigned 8803 patients who had had myocardial infarction, treatment with 160 mg aspirin, 3 mg warfarin with 80 mg aspirin, or 1 mg warfarin with 80 mg aspirin. Patients took a single tablet daily, and attended for prothrombin time (PT) measurements at weeks 1, 2, 3, 4, 6, and 12, and then every 3 months. Patients were followed up for a maximum of 33 months (median 14

1997 Lancet Controlled trial quality: predicted high

510. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. (PubMed)

Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. Inflammation may be important in the pathogenesis of atherothrombosis. We studied whether inflammation increases the risk of a first thrombotic event and whether treatment with aspirin decreases the risk.We measured plasma C-reactive protein, a marker for systemic inflammation, in 543 apparently healthy men participating in the Physicians' Health Study in whom myocardial infarction, stroke, or venous (...) thrombosis subsequently developed, and in 543 study participants who did not report vascular disease during a follow-up period exceeding eight years. Subjects were randomly assigned to receive aspirin or placebo at the beginning of the trial.Base-line plasma C-reactive protein concentrations were higher among men who went on to have myocardial infarction (1.51 vs. 1.13 mg per liter, P<0.001) or ischemic stroke (1.38 vs. 1.13 mg per liter, P=0.02), but not venous thrombosis (1.26 vs. 1.13 mg per liter, P

1997 NEJM Controlled trial quality: uncertain

511. CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group. (PubMed)

CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group. Aspirin is effective in the treatment of acute myocardial infarction and in the long-term prevention of serious vascular events in survivors of stroke and myocardial infarction. There is, however, no reliable evidence on the effectiveness of early aspirin use in acute ischaemic stroke.The Chinese Acute Stroke Trial (CAST (...) ) was a large randomised, placebo-controlled trial of the effects in hospital of aspirin treatment (160 mg/day) started within 48 h of the onset of suspected acute ischaemic stroke and continued in hospital for up to 4 weeks. The primary endpoints were death from any cause during the 4-week treatment period and death or dependence at discharge, and the analyses were by intention to treat. 21,106 patients with acute ischaemic stroke were enrolled in 413 Chinese hospitals at a mean of 25 h after the onset

1997 Lancet Controlled trial quality: predicted high

512. Prednisone and aspirin in women with autoantibodies and unexplained recurrent fetal loss. (PubMed)

Prednisone and aspirin in women with autoantibodies and unexplained recurrent fetal loss. Recurrent fetal loss has been well described in women with antiphospholipid antibodies. Such women also often have other autoantibodies commonly found in patients with systemic lupus erythematosus. Treating them with prednisone and aspirin may reduce the risk of fetal loss.We screened 773 nonpregnant women who had the unexplained loss of at least two fetuses for antinuclear, anti-DNA, antilymphocyte (...) , and anticardiolipin antibodies and for the lupus anticoagulant. Of 385 women with at least one autoantibody, 202 who later became pregnant were randomly assigned in equal numbers to receive either prednisone (0.5 to 0.8 mg per kilogram of body weight per day) and aspirin (100 mg per day) or placebo for the duration of the pregnancy. The women were stratified according to age (18 to 34 years or 35 to 39 years) and the week of gestation at which the previous fetal losses had occurred (< or = 12 or > 12 weeks

1997 NEJM Controlled trial quality: predicted high

513. Randomised controlled trial of ketanserin and aspirin in prevention of pre-eclampsia. (PubMed)

Randomised controlled trial of ketanserin and aspirin in prevention of pre-eclampsia. Pre-eclampsia is associated with extensive endothelial-cell damage and platelet activation, resulting in lower production of vasodilator prostaglandins and increased release of the vasoconstrictors thromboxane A2 and serotonin. Damage to endothelial-cell serotonin-1 receptors leaves vasoconstriction and platelet aggregation mediated by serotonin-2 receptors unopposed. We investigated the role of ketanserin (...) , a selective serotonin-2-receptor antagonist, in lowering the rate of pre-eclampsia among pregnant women with mild to moderate hypertension.We recruited 138 pregnant women into a double-blind, randomised, placebo-controlled trial. They had diastolic blood pressure persistently more than 80 mm Hg before 20 weeks' gestation. 69 women received ketanserin and 69 received placebo. Both groups also received aspirin. Patients were initially given two tablets daily, increased to four tablets daily in diastolic

1997 Lancet Controlled trial quality: predicted high

514. The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. International Stroke Trial Collaborative Group. (PubMed)

The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. International Stroke Trial Collaborative Group. Only a few small trials have compared antithrombotic therapy (antiplatelet or anticoagulant agents) versus control in acute ischaemic stroke, and none has been large enough to provide reliable evidence on safety or efficacy.The International Stroke Trial (IST) was a large, randomised, open (...) trial of up to 14 days of antithrombotic therapy started as soon as possible after stroke onset. The aim was to provide reliable evidence on the safety and efficacy of aspirin and of subcutaneous heparin. Half the patients were allocated unfractionated heparin (5000 or 12,500 IU bd [twice daily]), and half were allocated "avoid heparin"; and, in a factorial design, half were allocated aspirin 300 mg daily and half "avoid aspirin". The primary outcomes were death within 14 days and death

1997 Lancet Controlled trial quality: predicted high

515. Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina. A meta-analysis. (PubMed)

Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina. A meta-analysis. To estimate the risk of myocardial infarction (MI) and death in patients with unstable angina who are treated with aspirin plus heparin compared with patients treated with aspirin alone.Studies were retrieved using MEDLINE, bibliographies, and consultation with experts.Only published trials that enrolled patients with unstable angina, randomized participants (...) to aspirin plus heparin vs aspirin alone, and reported incidence of myocardial infarction or death were included in the meta-analysis.Patient outcomes including MI or death, recurrent ischemic pain, and major bleeding during randomized treatment; revascularization procedures after randomization; and MI or death during the 2 to 12 weeks following randomization were extracted by 2 authors, 1 of whom was blinded to the journal, institution, and author of each study.Six randomized trials were included

1996 JAMA

516. Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina: a meta-analysis

Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina: a meta-analysis Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina: a meta-analysis Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina: a meta-analysis Oler A, Whooley M A, Oler J, Grady D Authors' objectives To determine whether treatment (...) with intravenous heparin and aspirin is more effective than treatment with aspirin alone, in preventing myocardial infarction (MI) or death in patients with unstable angina. Searching MEDLINE was searched from January 1966 to September 1995 for articles published in any language using the keywords 'aspirin', 'heparin' and 'unstable angina'. Additonal material was obtained by handsearching of references from identified articles, and by consultation with experts. Study selection Study designs of evaluations

1996 DARE.

517. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. (PubMed)

A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Many clinical trials have evaluated the benefit of long-term use of antiplatelet drugs in reducing the risk of clinical thrombotic events. Aspirin and ticlopidine have been shown to be effective, but both have potentially serious adverse effects. Clopidogrel, a new thienopyridine derivative similar to ticlopidine, is an inhibitor of platelet aggregation induced (...) by adenosine diphosphate.CAPRIE was a randomised, blinded, international trial designed to assess the relative efficacy of clopidogrel (75 mg once daily) and aspirin (325 mg once daily) in reducing the risk of a composite outcome cluster of ischaemic stroke, myocardial infarction, or vascular death; their relative safety was also assessed. The population studied comprised subgroups of patients with atherosclerotic vascular disease manifested as either recent ischaemic stroke, recent myocardial infarction

1996 Lancet Controlled trial quality: predicted high

518. A comparison of aspirin and anticoagulation following thrombolysis for myocardial infarction (the AFTER study): a multicentre unblinded randomised clinical trial. (PubMed)

A comparison of aspirin and anticoagulation following thrombolysis for myocardial infarction (the AFTER study): a multicentre unblinded randomised clinical trial. To compare aspirin with anticoagulation with regard to risk of cardiac death and reinfarction in patients who received anistreplase thrombolysis for myocardial infarction.A multicentre unblinded randomised clinical trial.38 hospitals in six countries.1036 patients who had been treated with anistreplase for myocardial infarction were (...) randomly assigned to either aspirin (150 mg daily) or anticoagulation (intravenous heparin followed by warfarin or other oral anticoagulant). The trial was stopped earlier than originally intended because of the slowing rate of recruitment.Cardiac death or recurrent myocardial infarction at 30 days.After 30 days cardiac death or reinfarction, occurred in 11.0% (57/517) of the patients treated with anticoagulation and 11.2% (58/519) of the patients treated with aspirin (odds ratio 1.02, 95% confidence

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1996 BMJ Controlled trial quality: predicted high

519. Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation: Stroke Prevention in Atrial Fibrillation III randomised clinical trial. (PubMed)

Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation: Stroke Prevention in Atrial Fibrillation III randomised clinical trial. Adjusted-dose warfarin is highly efficacious for prevention of ischaemic stroke in patients with atrial fibrillation (AF). However, this treatment carries a risk of bleeding and the need for frequent medical monitoring. We sought an alternative that would be safer and easier to administer (...) to patients with AF who are at high-risk of thromboembolism.1044 patients with AF and with at least one thromboembolic risk factor (congestive heart failure or left ventricular fractional shortening < or = 25%, previous thromboembolism, systolic blood pressure of more than 160 mm Hg at study enrollment, or being a woman aged over 75 years) were randomly assigned either a combination of low-intensity, fixed-dose warfarin (international normalised ratio [INR] 1.2-1.5 for initial dose adjustment) and aspirin

1996 Lancet Controlled trial quality: uncertain

520. Aspirin and myocardial infarction

Aspirin and myocardial infarction Aspirin and myocardial infarction Aspirin and myocardial infarction NHS Centre for Reviews and Dissemination 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 NHS Centre for Reviews and Dissemination. Aspirin and myocardial infarction. York: Centre for Reviews and Dissemination (CRD) 1995: 4 Authors (...) ' objectives To summarise the evidence relating to the use of aspirin following myocardial infarction. Authors' conclusions Aspirin as emergency therapy: Aspirin is an effective therapy in patients with acute myocardial infarction. Patients with suspected acute myocardial infarction should receive 150mg aspirin daily. There are very few contraindications for the immediate use of aspirin. Intravenous thrombolytic therapy: Intravenous thrombolytic therapy is also effective in suitable patients. The benefit

1995 Health Technology Assessment (HTA) Database.