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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
1. Ticagrelor Added to Aspirin in Acute Nonsevere Ischemic Stroke or Transient Ischemic Attack of Atherosclerotic Origin Full Text available with Trip Pro
Stroke or Transient Ischemic Attack Treated With Ticagrelor and ASA for Prevention of Stroke and Death) trial, we randomized patients with a noncardioembolic, nonsevere ischemic stroke, or high-risk transient ischemic attack to ticagrelor (180 mg loading dose on day 1 followed by 90 mg twice daily for days 2-30) or placebo added to aspirin (300-325 mg on day 1 followed by 75-100 mg daily for days 2-30) within 24 hours of symptom onset. The present paper reports a prespecified analysis in patients (...) Ticagrelor Added to Aspirin in Acute Nonsevere Ischemic Stroke or Transient Ischemic Attack of Atherosclerotic Origin Ticagrelor Added to Aspirin in Acute Nonsevere Ischemic Stroke or Transient Ischemic Attack of Atherosclerotic Origin - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. COVID-19 is an emerging, rapidly evolving
2021 EvidenceUpdates
2. Effect of Adding Ticagrelor to Standard Aspirin on Saphenous Vein Graft Patency in Patients Undergoing Coronary Artery Bypass Grafting (POPular CABG): A Randomized, Double-Blind, Placebo-Controlled Trial
Effect of Adding Ticagrelor to Standard Aspirin on Saphenous Vein Graft Patency in Patients Undergoing Coronary Artery Bypass Grafting (POPular CABG): A Randomized, Double-Blind, Placebo-Controlled Trial Effect of Adding Ticagrelor to Standard Aspirin on Saphenous Vein Graft Patency in Patients Undergoing Coronary Artery Bypass Grafting (POPular CABG): A Randomized, Double-Blind, Placebo-Controlled Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage (...) Display options Format Share Permalink Copy Page navigation Circulation Actions . 2020 Nov 10;142(19):1799-1807. doi: 10.1161/CIRCULATIONAHA.120.050749. Epub 2020 Aug 31. Effect of Adding Ticagrelor to Standard Aspirin on Saphenous Vein Graft Patency in Patients Undergoing Coronary Artery Bypass Grafting (POPular CABG): A Randomized, Double-Blind, Placebo-Controlled Trial , # , # , , , , , , , , , , , , , , , , , , , , , Affiliations Expand Affiliations 1 Department of Cardiology (L.M.W., P.W.A.J
2020 EvidenceUpdates
3. Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS
Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History (...) navigation Eur Heart J Actions . 2020 Oct 1;41(37):3533-3545. doi: 10.1093/eurheartj/ehaa670. Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Affiliations Expand Affiliations 1 Department of Cardiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. 2 Department of Cardiology
2020 EvidenceUpdates
4. In established atherosclerosis, P2Y12 inhibitor vs. aspirin monotherapy reduces MI but not stroke or mortality. (Abstract)
In established atherosclerosis, P2Y12 inhibitor vs. aspirin monotherapy reduces MI but not stroke or mortality. Chiarito M, Sanz-Sánchez J, Cannata F, et al. Monotherapy with a P2Y12 inhibitor or aspirin for secondary prevention in patients with established atherosclerosis: a systematic review and meta-analysis. Lancet. 2020;395;1487-95. 32386592.
2020 Annals of Internal Medicine
5. In AF with recent ACS or PCI, apixaban improved 30-day outcomes vs. VKAs; aspirin effects varied vs. placebo. (Abstract)
In AF with recent ACS or PCI, apixaban improved 30-day outcomes vs. VKAs; aspirin effects varied vs. placebo. Alexander JH, Wojdyla D, Vora AN, et al. Risk/benefit tradeoff of antithrombotic therapy in patients with atrial fibrillation early and late after an acute coronary syndrome or percutaneous coronary intervention: insights from AUGUSTUS. Circulation. 2020;141:1618-27. 32223444.
2020 Annals of Internal Medicine
6. AORN, ASA, and APSF Clarification of Powered Air-Purifying Respirator (PAPR) Use in the Operating Room and Other Procedural Areas in Which Sterile Fields are Present
AORN, ASA, and APSF Clarification of Powered Air-Purifying Respirator (PAPR) Use in the Operating Room and Other Procedural Areas in Which Sterile Fields are Present AORN, ASA, and APSF Clarification of Powered Air-Purifying Respirator (PAPR) Use in the Operating Room and Other Procedural Areas in Which Sterile Fields are Present | American Society of Anesthesiologists (ASA) Menu Menu Close Guidelines, Statements, Clinical Resources Back Guidelines, Statements, Clinical Resources ASA Community (...) Back ASA Community Advocacy & ASAPAC Back Advocacy & ASAPAC Education and Career Back Education and Career Events Back Events In the Spotlight Back In the Spotlight Podcasts Back Podcasts Quality and Practice Management Back Quality and Practice Management Research and Publications Back Research and Publications Member Center Back Member Center About ASA Back About ASA News June 30, 2020 AORN, ASA, and APSF Clarification of Powered Air-Purifying Respirator (PAPR) Use in the Operating Room and Other
2020 American Society of Anesthesiologists
7. ASA-APSF Joint Statement on the Necessity of Wearing Face Masks in Public Full Text available with Trip Pro
ASA-APSF Joint Statement on the Necessity of Wearing Face Masks in Public ASA-APSF Joint Statement on the Necessity of Wearing Face Masks in Public Menu Menu Close Guidelines, Statements, Clinical Resources Back Guidelines, Statements, Clinical Resources ASA Community Back ASA Community Advocacy & ASAPAC Back Advocacy & ASAPAC Education and Career Back Education and Career Events Back Events In the Spotlight Back In the Spotlight Podcasts Back Podcasts Quality and Practice Management Back (...) Quality and Practice Management Research and Publications Back Research and Publications Member Center Back Member Center About ASA Back About ASA News June 30, 2020 ASA-APSF Joint Statement on the Necessity of Wearing Face Masks in Public (PDF) The American Society of Anesthesiologists (ASA) and the Anesthesia Patient Safety Foundation (APSF) strongly urge all persons over the age of 2 to cover their nose and mouth with a cloth or disposable face mask while in public. Recent studies have found
2020 American Society of Anesthesiologists
8. Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial
Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. COVID-19 is an emerging, rapidly evolving (...) in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial , , , , , , , , , , , , , Affiliations Expand Affiliations 1 School of Public Health & Preventive Medicine, Monash University Faculty of Medicine Nursing and Health Sciences, Melbourne, Victoria, Australia suzanne.mahady@monash.edu. 2 Gastroenterology, Melbourne Health, Parkville, Victoria, Australia. 3 HealthPartners Institute, Minneapolis, Minnesota, USA. 4 Clinical and Translational Epidemiology Unit
2020 EvidenceUpdates
9. The Safety and Efficacy of Aspirin Discontinuation on a Background of a P2Y12 Inhibitor in Patients After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis
The Safety and Efficacy of Aspirin Discontinuation on a Background of a P2Y12 Inhibitor in Patients After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis The Safety and Efficacy of Aspirin Discontinuation on a Background of a P2Y 12 Inhibitor in Patients After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard (...) navigation Circulation Actions . 2020 Aug 11;142(6):538-545. doi: 10.1161/CIRCULATIONAHA.120.046251. Epub 2020 Jun 19. The Safety and Efficacy of Aspirin Discontinuation on a Background of a P2Y 12 Inhibitor in Patients After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis , , Affiliations Expand Affiliation 1 TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA. PMID: 32551860 DOI: Item in Clipboard The Safety and Efficacy of Aspirin
2020 EvidenceUpdates
10. SMFM Special Statement: Checklists for preeclampsia risk-factor screening to guide recommendations for prophylactic low-dose aspirin
SMFM Special Statement: Checklists for preeclampsia risk-factor screening to guide recommendations for prophylactic low-dose aspirin Society for Maternal-Fetal Medicine Special Statement: Checklists for preeclampsia risk-factor screening to guide recommendations for prophylactic low-dose aspirin - American Journal of Obstetrics & Gynecology Go search , PB7-B11, September 01, 2020 Powered By Mendeley Share on Society for Maternal-Fetal Medicine Special Statement: Checklists for preeclampsia risk (...) -factor screening to guide recommendations for prophylactic low-dose aspirin SMFM Patient Safety and Quality Committee ∗ C. Andrew Combs Affiliations Patient Safety and Quality Improvement Committee, Society for Maternal-Fetal Medicine, Washington, DC Douglas M. Montgomery Affiliations Patient Safety and Quality Improvement Committee, Society for Maternal-Fetal Medicine, Washington, DC Published: June 14, 2020 DOI: In pregnant individuals with risk factors for preeclampsia, prophylactic low-dose
2020 Society for Maternal-Fetal Medicine
11. Aspirin (single dose) for perineal pain in the early postpartum period. (Abstract)
with newborn care and the establishment of breastfeeding. Aspirin has been used in the management of postpartum perineal pain, and its effectiveness and safety should be assessed. This is an update of the review, last published in 2017.To determine the effects of a single dose of aspirin (acetylsalicylic acid), including at different doses, in the relief of acute postpartum perineal pain.For this update, we searched the Cochrane Pregnancy and Childbirth's Trials Register (4 October 2019 (...) Aspirin (single dose) for perineal pain in the early postpartum period. Perineal trauma, due to spontaneous tears, surgical incision (episiotomy), or in association with operative vaginal birth, is common after vaginal birth, and is often associated with postpartum perineal pain. Birth over an intact perineum may also lead to perineal pain. There are adverse health consequences associated with perineal pain for the women and their babies in the short- and long-term, and the pain may interfere
2020 Cochrane
12. Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA. (Abstract)
Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA. Trials have evaluated the use of clopidogrel and aspirin to prevent stroke after an ischemic stroke or transient ischemic attack (TIA). In a previous trial, ticagrelor was not better than aspirin in preventing vascular events or death after stroke or TIA. The effect of the combination of ticagrelor and aspirin on prevention of stroke has not been well studied.We conducted a randomized, placebo-controlled, double-blind (...) trial involving patients who had had a mild-to-moderate acute noncardioembolic ischemic stroke, with a National Institutes of Health Stroke Scale (NIHSS) score of 5 or less (range, 0 to 42, with higher scores indicating more severe stroke), or TIA and who were not undergoing thrombolysis or thrombectomy. The patients were assigned within 24 hours after symptom onset, in a 1:1 ratio, to receive a 30-day regimen of either ticagrelor (180-mg loading dose followed by 90 mg twice daily) plus aspirin (300
2020 NEJM
13. The COMPASS Trial: Net Clinical Benefit of Low-Dose Rivaroxaban Plus Aspirin as Compared With Aspirin in Patients With Chronic Vascular Disease Full Text available with Trip Pro
: 10.1161/CIR.0000000000000880. Epub 2020 Jul 6. Circulation. 2020. PMID: 32628554 No abstract available. Abstract Background: Rivaroxaban 2.5 mg twice daily plus acetylsalicylic acid (aspirin; ASA) 100 mg reduced the risk of cardiovascular events as compared with ASA monotherapy in the COMPASS trial (Cardiovascular Outcomes for People Using Anticoagulation Strategies) but increased the risk of major bleedings. Analysis of net clinical benefit (NCB) is of key clinical relevance and represents (...) The COMPASS Trial: Net Clinical Benefit of Low-Dose Rivaroxaban Plus Aspirin as Compared With Aspirin in Patients With Chronic Vascular Disease The COMPASS Trial: Net Clinical Benefit of Low-Dose Rivaroxaban Plus Aspirin as Compared With Aspirin in Patients With Chronic Vascular Disease - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily
2020 EvidenceUpdates
14. Effect of Aspirin vs Placebo on the Prevention of Depression in Older People: A Randomized Clinical Trial
Effect of Aspirin vs Placebo on the Prevention of Depression in Older People: A Randomized Clinical Trial Effect of Aspirin vs Placebo on the Prevention of Depression in Older People: A Randomized Clinical Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health National Library of Medicine National (...) RSS Cancel RSS Link Copy Actions Cite Share Permalink Copy Page navigation JAMA Psychiatry Actions . 2020 Jun 3;e201214. doi: 10.1001/jamapsychiatry.2020.1214. Online ahead of print. Effect of Aspirin vs Placebo on the Prevention of Depression in Older People: A Randomized Clinical Trial , , , , , , , , , , , , , , , , Affiliations Expand Affiliations 1 The Institute for Mental and Physical Health and Clinical Translation Strategy Research Centre, Deakin University School of Medicine, Geelong
2020 EvidenceUpdates
15. Effect of Ticagrelor Monotherapy vs Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events in Patients With Acute Coronary Syndrome: The TICO Randomized Clinical Trial. (Abstract)
Effect of Ticagrelor Monotherapy vs Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events in Patients With Acute Coronary Syndrome: The TICO Randomized Clinical Trial. Discontinuing aspirin after short-term dual antiplatelet therapy (DAPT) was evaluated as a bleeding reduction strategy. However, the strategy of ticagrelor monotherapy has not been exclusively evaluated in patients with acute coronary syndromes (ACS).To determine whether switching to ticagrelor monotherapy after 3
2020 JAMA
16. Cancer prevention with aspirin in hereditary colorectal cancer (Lynch syndrome), 10-year follow-up and registry-based 20-year data in the CAPP2 study: a double-blind, randomised, placebo-controlled trial. Full Text available with Trip Pro
Cancer prevention with aspirin in hereditary colorectal cancer (Lynch syndrome), 10-year follow-up and registry-based 20-year data in the CAPP2 study: a double-blind, randomised, placebo-controlled trial. Lynch syndrome is associated with an increased risk of colorectal cancer and with a broader spectrum of cancers, especially endometrial cancer. In 2011, our group reported long-term cancer outcomes (mean follow-up 55·7 months [SD 31·4]) for participants with Lynch syndrome enrolled (...) into a randomised trial of daily aspirin versus placebo. This report completes the planned 10-year follow-up to allow a longer-term assessment of the effect of taking regular aspirin in this high-risk population.In the double-blind, randomised CAPP2 trial, 861 patients from 43 international centres worldwide (707 [82%] from Europe, 112 [13%] from Australasia, 38 [4%] from Africa, and four [<1%] from The Americas) with Lynch syndrome were randomly assigned to receive 600 mg aspirin daily or placebo. Cancer
2020 Lancet
17. Randomized placebo-controlled trial of the effects of aspirin on dementia and cognitive decline Full Text available with Trip Pro
Randomized placebo-controlled trial of the effects of aspirin on dementia and cognitive decline Randomized Placebo-Controlled Trial of the Effects of Aspirin on Dementia and Cognitive Decline - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health National Library of Medicine National Center for Biotechnology (...) Actions Cite Share Permalink Copy Page navigation Neurology Actions . 2020 Mar 25;10.1212/WNL.0000000000009277. doi: 10.1212/WNL.0000000000009277. Online ahead of print. Randomized Placebo-Controlled Trial of the Effects of Aspirin on Dementia and Cognitive Decline , , , , , , , , , , , , , , , , , , Affiliations Expand Affiliations 1 From the School of Public Health and Preventive Medicine (J.R., E.S., R.L.W., R.W., C.M.R., S.A.W., J.E.L., S.G.O., R.T., J.J.M.) and the Turner Institute for Brain
2020 EvidenceUpdates
18. Ticagrelor With or Without Aspirin in High-Risk Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention Full Text available with Trip Pro
Ticagrelor With or Without Aspirin in High-Risk Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention Ticagrelor With or Without Aspirin in High-Risk Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health (...) Feed: Number of items displayed: Create RSS Cancel RSS Link Copy Actions Cite Share Permalink Copy Page navigation J Am Coll Cardiol Actions . 2020 May 19;75(19):2403-2413. doi: 10.1016/j.jacc.2020.03.008. Epub 2020 Mar 30. Ticagrelor With or Without Aspirin in High-Risk Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention , , , , , , , , , , , , , , , , , , , , , , , , Affiliations Expand Affiliations 1 Division of Cardiology, University of Florida College of Medicine
2020 EvidenceUpdates
19. Monotherapy with a P2Y<sub>12</sub> inhibitor or aspirin for secondary prevention in patients with established atherosclerosis: a systematic review and meta-analysis. (Abstract)
Monotherapy with a P2Y12 inhibitor or aspirin for secondary prevention in patients with established atherosclerosis: a systematic review and meta-analysis. Antiplatelet therapy is recommended among patients with established atherosclerosis. We compared monotherapy with a P2Y12 inhibitor versus aspirin for secondary prevention.In this systematic review and meta-analysis, all randomised trials comparing P2Y12 inhibitor with aspirin monotherapy for secondary prevention in patients (...) determining study inclusion (ie, cerebrovascular, coronary, or peripheral artery disease), P2Y12 inhibitor type and dosage, aspirin dosage, endpoint definitions, effect estimates, follow-up duration, and percentage of patients lost to follow-up were collected. Odds ratios (ORs) and 95% CIs were used as metric of choice for treatment effects with random-effects models. Co-primary endpoints were myocardial infarction and stroke. Key secondary endpoints were all-cause death and vascular death. Heterogeneity
2020 Lancet
20. Aspirin or heparin or both for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss. (Abstract)
Aspirin or heparin or both for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss. Aspirin and heparin are widely used as preventive strategy to reduce the high risk of recurrent pregnancy loss in women with antiphospholipid antibodies (aPL). This review supersedes a previous, out-of-date review that evaluated all potential therapies for preventing recurrent pregnancy loss in women with aPL. The current review focusses on a narrower (...) scope because current clinical practice is restricted to using aspirin or heparins, or both for women with aPL in an attempt to reduce pregnancy complications.To assess the effects of aspirin or heparin, or both for improving pregnancy outcomes in women with persistent (on two separate occasions) aPL, either lupus anticoagulant (LAC), anticardiolipin (aCL) or aβ2-glycoprotein-I antibodies (aβ2GPI) or a combination, and recurrent pregnancy loss (two or more, which do not have to be consecutive).We