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

541. Prevention of serious cardiac events by low-dose aspirin in patients with silent myocardial ischaemia. The Research Group on Instability in Coronary Artery Disease in Southeast Sweden. (PubMed)

Prevention of serious cardiac events by low-dose aspirin in patients with silent myocardial ischaemia. The Research Group on Instability in Coronary Artery Disease in Southeast Sweden. On exercise testing after an episode of unstable coronary artery disease (CAD; unstable angina or non-Q-wave myocardial infarction), a proportion of patients show ST-segment depression, indicating myocardial ischaemia, but do not report concomitant symptoms of angina. Treatment of such "silent" ischaemia aims (...) mainly to reduce the risk of subsequent cardiac events. We have studied the effect of low-dose aspirin in patients with myocardial ischaemia defined at the predischarge test as silent (though patients might have had symptomatic ischaemia at other times) or symptomatic. 740 men with unstable CAD aged 70 years or less underwent symptom-limited exercise testing before hospital discharge; 144 showed ST depression without pain and 230 ST depression with simultaneous chest pain. Of the silent ischaemia

1992 Lancet Controlled trial quality: uncertain

542. Low-dose aspirin to prevent pregnancy-induced hypertensive disease. (PubMed)

Low-dose aspirin to prevent pregnancy-induced hypertensive disease. 1835503 1991 12 30 2016 10 17 0098-7484 266 22 1991 Dec 11 JAMA JAMA Low-dose aspirin to prevent pregnancy-induced hypertensive disease. 3126-8 eng Comment Letter Meta-Analysis United States JAMA 7501160 0098-7484 R16CO5Y76E Aspirin AIM IM JAMA. 1991 Jul 10;266(2):260-4 1829118 Aspirin administration & dosage Female Humans Hypertension drug therapy Meta-Analysis as Topic Pregnancy Pregnancy Complications, Cardiovascular drug

1991 JAMA

543. A meta-analysis of low-dose aspirin for the prevention of pregnancy-induced hypertensive disease. (PubMed)

A meta-analysis of low-dose aspirin for the prevention of pregnancy-induced hypertensive disease. --Pregnancy-induced hypertension (PIH), defined as either isolated hypertension after the 20th week of gestation or hypertension with proteinuria (preeclampsia), occurs in 5% to 15% of pregnancies and is associated with maternal and neonatal morbidity. Previous clinical trials with small numbers of patients have suggested that aspirin in doses of 60 to 150 mg/d during the second and third (...) trimesters reduces the risk of PIH and improves maternal and neonatal outcomes.--We performed a meta-analysis of the six published controlled trials to estimate more precisely (1) the magnitude of protection of aspirin from PIH; (2) the effect of aspirin on severe low-birth-weight infants, cesarean section, and perinatal mortality; and (3) the risk of adverse effects.--We critically and independently evaluated study methods, assigned a quality score to each trial, and abstracted quantitative outcomes

1991 JAMA

544. A comparison of two doses of aspirin (30 mg vs. 283 mg a day) in patients after a transient ischemic attack or minor ischemic stroke. The Dutch TIA Trial Study Group. (PubMed)

A comparison of two doses of aspirin (30 mg vs. 283 mg a day) in patients after a transient ischemic attack or minor ischemic stroke. The Dutch TIA Trial Study Group. Aspirin is known to improve the outcome of patients who have had a cerebral transient ischemic attack, but the optimal dose of aspirin remains uncertain. Experimental evidence indicates that 30 mg of aspirin daily alters platelet aggregation more favorably than the 300-mg dose currently used in patients after transient ischemic (...) attack or minor ischemic stroke.We assessed the effects of two doses of a water-soluble preparation of acetylsalicylic acid, or aspirin (30 mg vs. 283 mg a day), on the occurrence of death from all vascular causes, nonfatal stroke, or nonfatal myocardial infarction in a double-blind, randomized, controlled clinical trial in patients who had had a transient ischemic attack or minor stroke. A total of 3131 patients participated in the study. The mean follow-up was 2.6 years.In the group assigned

1991 NEJM Controlled trial quality: predicted high

545. Suppression of thromboxane A2 but not of systemic prostacyclin by controlled-release aspirin. (PubMed)

Suppression of thromboxane A2 but not of systemic prostacyclin by controlled-release aspirin. The antithrombotic efficacy of aspirin is attributed to its inhibition of the enzyme prostaglandin G/H synthase, which is necessary for the formation of thromboxane A2 in platelets. Thromboxane A2 is a potent vasoconstrictor and platelet agonist. However, the formation of prostacyclin by vascular endothelium also requires prostaglandin G/H synthase, and prostacyclin exerts opposite effects on platelet (...) function and vascular tone. We wanted to see whether controlled-release aspirin would affect the formation of thromboxane A2 but not prostacyclin by reducing the aspirin concentration that reaches the posthepatic circulation.A controlled-release formulation containing 75 mg of aspirin, designed to release 10 mg per hour, was developed to inhibit prostaglandin G/H synthase in platelets in the prehepatic circulation. The effects of the controlled-release preparation on plasma levels of aspirin

1991 NEJM Controlled trial quality: uncertain

546. Swedish Aspirin Low-Dose Trial (SALT) of 75 mg aspirin as secondary prophylaxis after cerebrovascular ischaemic events. The SALT Collaborative Group. (PubMed)

Swedish Aspirin Low-Dose Trial (SALT) of 75 mg aspirin as secondary prophylaxis after cerebrovascular ischaemic events. The SALT Collaborative Group. The efficacy of aspirin in daily doses of 300 mg and more as secondary prophylaxis after cerebrovascular events is well established. Since much lower doses of aspirin can inhibit platelet function, and carry a lower risk of adverse effects, the Swedish Aspirin Low-dose Trial (SALT) was set up to study the efficacy of 75 mg aspirin daily (...) in prevention of stroke and death after transient ischaemic attack (TIA) or minor stroke. 1360 patients entered the study 1-4 months after the qualifying event: 676 were randomly assigned to aspirin treatment and 684 to placebo treatment. The median duration of follow-up was 32 months. Compared with the placebo group, the aspirin group showed a reduction of 18% in the risk of primary outcome events (stroke or death; relative risk 0.82, 95% confidence interval 0.67-0.99; log-rank analysis p = 0.02

1991 Lancet Controlled trial quality: predicted high

547. Prevention of fetal growth retardation with low-dose aspirin: findings of the EPREDA trial. (PubMed)

Prevention of fetal growth retardation with low-dose aspirin: findings of the EPREDA trial. The efficacy of low-dose aspirin in preventing fetal growth retardation was tested in a randomised, placebo-controlled, double-blind trial. A secondary aim was to find out whether dipyridamole improves the efficacy of aspirin. 323 women at 15-18 weeks' amenorrhoea were selected at twenty-five participating centres on the basis of fetal growth retardation and/or fetal death or abruptio placentae (...) in at least one previous pregnancy. They were randomly allocated to groups receiving placebo, 150 mg/day aspirin, or 150 mg/day aspirin plus 225 mg/day dipyridamole, for the remainder of the pregnancy. In the first phase of the trial all actively treated patients (n = 156) were compared with the placebo group (n = 73). Mean birthweight was significantly higher in the treated than in the placebo group (2751 [SD 670] vs 2526 [848] g; difference 225 g [95% CI 129-321 g], p = 0.029) and the frequency of fetal

1991 Lancet Controlled trial quality: predicted high

548. Effect of heparin, aspirin, or alteplase in reduction of myocardial ischaemia in refractory unstable angina. (PubMed)

Effect of heparin, aspirin, or alteplase in reduction of myocardial ischaemia in refractory unstable angina. 399 out of 474 inpatients with unstable angina were monitored for 48 h and 97 of these were found to be refractory to conventional antianginal treatments and entered a randomised double-blind study. With the initial protocol heparin infusion or bolus were compared with aspirin; with a modified protocol, heparin infusion, the best of these three treatments, was compared with alteplase (...) . Patients were monitored for 3 days after starting treatment and then observed clinically for 4 more days. On the first days of treatment heparin infusion significantly decreased the frequency of angina (by 84-94%), episodes of silent ischaemia (by 71-77%), and the overall duration of ischaemia (by 81-86%). Heparin bolus and aspirin were not effective. Alteplase caused small (non-significant) reductions on the first day only. Only minor bleeding complications occurred.

1990 Lancet Controlled trial quality: uncertain

549. Trial of iloprost versus aspirin treatment for critical limb ischaemia of thromboangiitis obliterans. The TAO Study. (PubMed)

Trial of iloprost versus aspirin treatment for critical limb ischaemia of thromboangiitis obliterans. The TAO Study. 152 patients with thromboangiitis obliterans (Buerger's disease) and pain from critical leg ischaemia were randomly allocated to receive iloprost, a chemically stable prostacyclin analogue, or low-dose aspirin, for 28 days in a double-blind trial. On review, 19 patients did not fulfil the stringent entry criteria. Of the other 133 patients, 98 also had leg ulcers. After 21-28 (...) days, 58 (85%) of 68 iloprost-treated patients showed ulcer healing or relief of ischaemic pain, compared with 11 (17%) of 65 in the aspirin-treated group. 43 (63%) on iloprost treatment had complete relief of pain, compared with 18 (28%) on aspirin. Ulcers healed completely in 18 of 52 (35%) who received iloprost compared with 6 of 46 (13%) who received aspirin. 6 months after the start of treatment, the response rate was 45 of 51 (88%) patients treated with iloprost compared with 12 of 44 (21

1990 Lancet Controlled trial quality: uncertain

550. Low-dose aspirin for migraine prophylaxis. (PubMed)

Low-dose aspirin for migraine prophylaxis. The Physicians' Health Study is a randomized, double-blind, placebo-controlled trial that studied low-dose aspirin (325 mg every other day) therapy among 22,071 US male physicians aged 40 to 84 years. Annual follow-up questionnaires requested information on the occurrence of numerous medical conditions including migraine. At the end of 60 months, morbidity follow-up was 99.7% complete, and the reported consumption of aspirin or other platelet-active (...) drugs was 86% in the aspirin group and 14% in the placebo group. Of those randomized to aspirin, 661 (6.0%) reported migraine at some time after randomization, as compared with 818 (7.4%) of those allocated to the placebo group, representing a statistically significant 20% reduction in recurrence rate. The rate of self-report of ordinary headache was similar in the two groups. These data indicate that migraine is mediated, at least in part, by the effects of platelets and suggest that low-dose

1990 JAMA Controlled trial quality: predicted high

551. Risk of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease. The RISC Group. (PubMed)

Risk of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease. The RISC Group. 796 men with unstable coronary artery disease (unstable angina or non-Q-wave myocardial infarction [MI] ), were randomised to double-blind placebo-controlled treatment with oral aspirin 75 mg/day and/or 5 days of intermittent intravenous heparin. The risk of MI and death was reduced by aspirin. After 5 days the risk ratio was 0.43 (...) (confidence intervals, 0.21-0.91), at 1 month 0.31 (0.18-0.53), and at 3 months 0.36 (0.23-0.57). Aspirin reduced event rate in non-Q-wave MI and unstable angina, independently of electrocardiographic abnormalities or concurrent drug therapy. Heparin had no significant influence on event rate, although the group treated with aspirin and heparin had the lowest number of events during the initial 5 days. Treatment had few side-effects and high patient compliance.

1990 Lancet Controlled trial quality: uncertain

552. Doppler ultrasound and aspirin in recognition and prevention of pregnancy-induced hypertension. (PubMed)

Doppler ultrasound and aspirin in recognition and prevention of pregnancy-induced hypertension. Screening of 1226 nulliparous women by means of doppler uteroplacental flow-velocity waveforms in early pregnancy identified 148 (12%) as being at high risk of pregnancy-induced hypertension. After exclusions and refusals, 100 women were randomly allocated to groups receiving either low-dose aspirin (75 mg daily; 48 patients) or identical placebo (52 patients) for the remainder of the pregnancy (...) . The difference between the aspirin and placebo groups in the frequency of pregnancy-induced hypertension (13% vs 25%) did not achieve significance, but there were significant differences in the frequencies of proteinuric hypertension (2% vs 19%) and hypertension occurring before 37 weeks' gestation (0% vs 17%). Fewer aspirin-treated than placebo-treated women had low birthweight babies (15% vs 25%), but this difference was not significant. The only perinatal death in the aspirin group followed a cord

1990 Lancet Controlled trial quality: uncertain

553. A comparison between heparin and low-dose aspirin as adjunctive therapy with tissue plasminogen activator for acute myocardial infarction. Heparin-Aspirin Reperfusion Trial (HART) Investigators. (PubMed)

A comparison between heparin and low-dose aspirin as adjunctive therapy with tissue plasminogen activator for acute myocardial infarction. Heparin-Aspirin Reperfusion Trial (HART) Investigators. We report the results of the Heparin-Aspirin Reperfusion Trial, a collaborative study comparing early intravenous heparin with oral aspirin as adjunctive treatment when recombinant tissue plasminogen activator (rt-PA) is used for coronary thrombolysis during acute myocardial infarction.Two hundred five (...) patients were randomly assigned to receive either immediate and then continuous intravenous heparin (starting with a 5000-unit bolus; n = 106) or immediate and then daily oral aspirin (80 mg; n = 99) together with rt-PA (100 mg intravenously over a six-hour period) initiated within six hours of the onset of symptoms. We evaluated the patency of the infarct-related artery by angiography 7 to 24 hours after beginning rt-PA infusion, the frequency of reocclusion of the artery by repeat angiography on day

1990 NEJM Controlled trial quality: uncertain

554. Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin. (PubMed)

Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin. To investigate the suitability of treatment with low dose aspirin or warfarin, or both, as possible prophylaxis against cardiovascular disease by determining the effect on gastric mucosal bleeding.Randomised crossover trial.Academic department of therapeutics.Twenty healthy male volunteers aged 19-22.On separate occasions and in randomised order all subjects received aspirin 75 mg, warfarin, or aspirin 75 mg combined (...) with warfarin. Each treatment was given for 12 days or (when warfarin was used) for longer if necessary until the international normalised ratio of the prothrombin time was stable at 1.4-1.6.Loss of blood over 10 minutes into gastric washings.Bleeding over 10 minutes into gastric washings under baseline conditions and after five days, and at end of each regimen of treatment. Aspirin 75 mg increased bleeding from 0.60 (95% confidence interval 0.36 to 0.99) microliters/10 minutes to 1.26 (0.71 to 2.25

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1989 BMJ Controlled trial quality: uncertain

555. Trial of low-dose aspirin plus dipyridamole versus anticoagulants for prevention of aortocoronary vein graft occlusion. (PubMed)

Trial of low-dose aspirin plus dipyridamole versus anticoagulants for prevention of aortocoronary vein graft occlusion. In a prospective randomised trial, 249 patients who had aortocoronary vein bypass surgery were assigned either to a platelet inhibitory drug regimen or to standard anticoagulant therapy. Treatment was replaced by placebo in half of the patients in each group after 3 months. The platelet inhibitory drug regimen--very low-dose aspirin combined with dipyridamole--was as effective

1989 Lancet Controlled trial quality: uncertain

556. The use of aspirin to prevent pregnancy-induced hypertension and lower the ratio of thromboxane A2 to prostacyclin in relatively high risk pregnancies. (PubMed)

The use of aspirin to prevent pregnancy-induced hypertension and lower the ratio of thromboxane A2 to prostacyclin in relatively high risk pregnancies. We carried out a prospective, randomized, double-blind, placebo-controlled study to investigate the capacity of aspirin to prevent pregnancy-induced hypertension and to alter prostaglandin metabolism. A total of 791 pregnant women with various risk factors for pre-eclamptic toxemia were screened with use of the rollover test (a comparison (...) of blood pressure before and after the woman rolls from her left side to her back) during week 28 or 29 of gestation. Of 69 women with abnormal results (an increase in blood pressure during the rollover test), 65 entered the study and were treated with a daily dose of either aspirin (100 mg; 34 women) or placebo (31 women) during the third trimester of pregnancy. The number of women in whom pregnancy-induced hypertension developed was significantly lower among the aspirin-treated than among the placebo

1989 NEJM Controlled trial quality: uncertain

557. Effect of low-dose aspirin on fetal and maternal generation of thromboxane by platelets in women at risk for pregnancy-induced hypertension. (PubMed)

Effect of low-dose aspirin on fetal and maternal generation of thromboxane by platelets in women at risk for pregnancy-induced hypertension. There is evidence that aspirin in low doses favorably influences the course of pregnancy-induced hypertension, but the mechanism, although assumed to involve suppression of the production of thromboxane by platelets, has not been established. We performed a randomized study of the effect of the long-term daily administration of 60 mg of aspirin (n = 17 (...) ) or placebo (n = 16) on platelet thromboxane A2 and vascular prostacyclin in women at risk for pregnancy-induced hypertension. Low doses of aspirin were associated with a longer pregnancy and increased weight of newborns. Serum levels of thromboxane B2, a stable product of thromboxane A2, were almost completely (greater than 90 percent) inhibited by low doses of aspirin. The urinary excretion of immunoreactive thromboxane B2 was significantly reduced without changes in the level of 6-keto-prostaglandin F1

1989 NEJM Controlled trial quality: uncertain

558. A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. Ticlopidine Aspirin Stroke Study Group. (PubMed)

A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. Ticlopidine Aspirin Stroke Study Group. We report the results of the Ticlopidine Aspirin Stroke Study, a blinded trial at 56 North American centers that compared the effects of ticlopidine hydrochloride (500 mg daily) with those of aspirin (1300 mg daily) on the risk of stroke or death. The medications were randomly assigned to 3069 patients with recent transient or mild (...) persistent focal cerebral or retinal ischemia. Follow-up lasted for two to six years. The three-year event rate for nonfatal stroke or death from any cause was 17 percent for ticlopidine and 19 percent for aspirin--a 12 percent risk reduction (95 percent confidence interval, -2 to 26 percent) with ticlopidine (P = 0.048 for cumulative Kaplan-Meier estimates). The rates of fatal and nonfatal stroke at three years were 10 percent for ticlopidine and 13 percent for aspirin--a 21 percent risk reduction (95

1989 NEJM Controlled trial quality: predicted high

559. Placebo-controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. The Copenhagen AFASAK study. (PubMed)

Placebo-controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. The Copenhagen AFASAK study. From November, 1985, to June, 1988, 1007 outpatients with chronic non-rheumatic atrial fibrillation (AF) entered a randomised trial; 335 received anticoagulation with warfarin openly, and in a double-blind study 336 received aspirin 75 mg once daily and 336 placebo. Each patient was followed up for 2 years or until termination (...) of the trial. The primary endpoint was a thromboembolic complication (stroke, transient cerebral ischaemic attack, or embolic complications to the viscera and extremities). The secondary endpoint was death. The incidence of thromboembolic complications and vascular mortality were significantly lower in the warfarin group than in the aspirin and placebo groups, which did not differ significantly. 5 patients on warfarin had thromboembolic complications compared with 20 patients on aspirin and 21 on placebo

1989 Lancet Controlled trial quality: predicted high

560. Final report on the aspirin component of the ongoing Physicians' Health Study. Steering Committee of the Physicians' Health Study Research Group. (PubMed)

Final report on the aspirin component of the ongoing Physicians' Health Study. Steering Committee of the Physicians' Health Study Research Group. The Physicians' Health Study is a randomized, double-blind, placebo-controlled trial designed to determine whether low-dose aspirin (325 mg every other day) decreases cardiovascular mortality and whether beta carotene reduces the incidence of cancer. The aspirin component was terminated earlier than scheduled, and the preliminary findings were (...) published. We now present detailed analyses of the cardiovascular component for 22,071 participants, at an average follow-up time of 60.2 months. There was a 44 percent reduction in the risk of myocardial infarction (relative risk, 0.56; 95 percent confidence interval, 0.45 to 0.70; P less than 0.00001) in the aspirin group (254.8 per 100,000 per year as compared with 439.7 in the placebo group). A slightly increased risk of stroke among those taking aspirin was not statistically significant; this trend

1989 NEJM Controlled trial quality: predicted high