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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
The cost-effectiveness of aspirin versus cyclooxygenase-2-selective inhibitors for colorectal carcinoma chemoprevention in healthy individuals The cost-effectiveness of aspirin versus cyclooxygenase-2-selective inhibitors for colorectal carcinoma chemoprevention in healthy individuals The cost-effectiveness of aspirin versus cyclooxygenase-2-selective inhibitors for colorectal carcinoma chemoprevention in healthy individuals Hur C, Simon L S, Gazelle G S 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 The use of aspirin versus cyclooxygenase-2-selective inhibitors (coxibs) as primary chemoprevention for colorectal carcinoma (CRC). Type of intervention Primary prevention. Economic study type Cost-utility analysis
Cost-effectiveness of aspirin chemoprevention for Barrett's esophagus Cost-effectiveness of aspirin chemoprevention for Barrett's esophagus Cost-effectiveness of aspirin chemoprevention for Barrett's esophagus Hur C, Nishioka N S, Gazelle G S 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 Four strategies for the management of Barrett's oesophagus (BE) to prevent oesophageal adenocarcinoma were studied. The strategies were aspirin therapy, endoscopic surveillance with biopsies, both, or neither. Type of intervention Secondary prevention. Economic study type Cost-utility analysis. Study population The hypothetical population was a cohort of 50,000 55-year-old men who had BE proven by endoscopic biopsy. The reason
Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST-segment-elevation acute coronary syndromes: a systematic review and economic evaluation Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST-segment-elevation acute coronary syndromes: a systematic review and economic evaluation Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST-segment-elevation acute (...) the use of 12-month clopidogrel in combination with aspirin for the prevention of morbidity and mortality associated with non-ST-segment elevation acute coronary syndrome (ACS). The combined therapy was compared with standard therapy including aspirin. Three alternative strategies (representing treatment with clopidogrel over a 1-, 3- or 6-month duration) were also considered. Type of intervention Secondary prevention. Economic study type Cost-utility analysis Study population The study population
Effect of ibuprofen on cardioprotective effect of aspirin. Treatment with ibuprofen might limit the cardioprotective effects of aspirin. We aimed to assess whether patients with known cardiovascular disease who take low-dose aspirin and ibuprofen have increased risk of cardiovascular mortality. We studied 7107 patients who were discharged after first admission for cardiovascular disease between April, 1989, and April, 1997, and who were prescribed low-dose aspirin (<325 mg/day) and survived (...) for at least 1 month. Compared with those who used aspirin alone, patients taking aspirin plus ibuprofen had an increased risk of all-cause mortality (adjusted hazard ratio 1.93, 95% CI 1.30-2.87, p=0.0011) and cardiovascular mortality (1.73, 1.05-2.84, p=0.0305). Our finding lends support to the hypothesis that ibuprofen may interact with the cardioprotective effects of aspirin, at least in patients with established cardiovascular disease.
Aspirin and ticlopidine for prevention of recurrent stroke in black patients: a randomized trial. Blacks are disproportionately affected by stroke, and they are about 2 times more likely than most other individuals in the United States to die of or experience stroke.To determine the efficacy and safety of aspirin and ticlopidine to prevent recurrent stroke in black patients.Randomized, double-blind, investigator-initiated, multicenter trial of 1809 black men and women who recently had (...) was halted after about 6.5 years when futility analyses revealed a less than 1% probability of ticlopidine being shown superior to aspirin in the prevention of the primary outcome end point. The primary outcome of recurrent stroke, myocardial infarction, or vascular death was reached by 133 (14.7%) of 902 patients assigned to ticlopidine and 112 (12.3%) of 907 patients assigned to aspirin (hazard ratio, 1.22; 95% confidence interval, 0.94-1.57). Kaplan-Meier curves for time to event for the primary
A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. Experimental studies in animals and observational studies in humans suggest that regular aspirin use may decrease the risk of colorectal adenomas, the precursors to most colorectal cancers.We conducted a randomized, double-blind trial to determine the effect of aspirin on the incidence of colorectal adenomas. We randomly assigned 635 patients with previous colorectal cancer to receive (...) either 325 mg of aspirin per day or placebo. We determined the proportion of patients with adenomas, the number of recurrent adenomas, and the time to the development of adenoma between randomization and subsequent colonoscopic examinations. Relative risks were adjusted for age, sex, cancer stage, the number of colonoscopic examinations, and the time to a first colonoscopy. The study was terminated early by an independent data and safety monitoring board when statistically significant results were
A randomized trial of aspirin to prevent colorectal adenomas. Laboratory and epidemiologic data suggest that aspirin has an antineoplastic effect in the large bowel.We performed a randomized, double-blind trial of aspirin as a chemopreventive agent against colorectal adenomas. We randomly assigned 1121 patients with a recent history of histologically documented adenomas to receive placebo (372 patients), 81 mg of aspirin (377 patients), or 325 mg of aspirin (372 patients) daily. According (...) after randomization in 1084 patients (97 percent). The incidence of one or more adenomas was 47 percent in the placebo group, 38 percent in the group given 81 mg of aspirin per day, and 45 percent in the group given 325 mg of aspirin per day (global P=0.04). Unadjusted relative risks of any adenoma (as compared with the placebo group) were 0.81 in the 81-mg group (95 percent confidence interval, 0.69 to 0.96) and 0.96 in the 325-mg group (95 percent confidence interval, 0.81 to 1.13). For advanced
Cost-effectiveness analysis of clopidogrel versus aspirin in patients with atherothrombosis based on the CAPRIE trial Cost-effectiveness analysis of clopidogrel versus aspirin in patients with atherothrombosis based on the CAPRIE trial Cost-effectiveness analysis of clopidogrel versus aspirin in patients with atherothrombosis based on the CAPRIE trial Annemans L, Lamotte M, Levy E, Lenne X Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion (...) , or symptomatic PAD. The mean age was 62.5 years. There were 9,553 patients in the clopidogrel group and 9,546 in the aspirin group. Additional information was taken from the CAPRIE study. Study design The study was an international, multi-centre, randomised controlled trial, with an average follow-up of 1.91 years. A total of 384 clinical centres from 16 countries participated. The patients were randomised to either 75-mg tablets of clopidogrel plus aspirin placebo or 325-mg tablets of aspirin plus
Indirect comparison meta-analysis of aspirin therapy after coronary surgery Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Aspirin for prevention of preeclampsia in women with historical risk factors: a systematic review Aspirin for prevention of preeclampsia in women with historical risk factors: a systematic review Aspirin for prevention of preeclampsia in women with historical risk factors: a systematic review Coomarasamy A, Honest H, Papaioannou S, Gee H, Khan K S CRD summary This review examined the effectiveness of aspirin in preventing perinatal death and pre-eclampsia in women with predisposing factors (...) . The authors concluded that aspirin can reduce the risk of pre-eclampsia and perinatal death in women who have known historical risk factors. Statements on the safety of aspirin were derived largely from observational studies, which were not part of the current systematic review. Authors' objectives To examine the effectiveness of aspirin in preventing perinatal death and pre-eclampsia in women with predisposing factors. Searching MEDLINE (from 1966 to 2001), EMBASE (from 1980 to 2001), the Cochrane
The efficacy of oral 5-ASAs in the treatment of active ulcerative colitis: a systematic review The efficacy of oral 5-ASAs in the treatment of active ulcerative colitis: a systematic review The efficacy of oral 5-ASAs in the treatment of active ulcerative colitis: a systematic review Kane S V, Bjorkman D J CRD summary This review assessed the efficacy of oral 5-aminosalicylic acid (5-ASA) agents for the treatment of mild to moderate active ulcerative colitis. The authors concluded (...) that mesalamine is superior to placebo and that 5-ASA products appear as effective as sulfasalazine, but there is no difference in efficacy between any of the 5-ASA preparations. The authors' conclusions are likely to be robust. Authors' objectives To assess the efficacy of oral 5-aminosalicylic acid (5-ASA) agents for the treatment of mild to moderate active ulcerative colitis (UC). Searching MEDLINE and EMBASE were searched from 1980 to 2002 without any language restrictions; the search terms were reported
Effects of aspirin consumption during pregnancy on pregnancy outcomes: meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
An update on aspirin in the primary prevention of cardiovascular disease Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Leukotriene-receptor expression on nasal mucosal inflammatory cells in aspirin-sensitive rhinosinusitis. Patients with asthma who have aspirin sensitivity have greater cysteinyl leukotriene production and greater airway hyperresponsiveness to the effects of inhaled cysteinyl leukotrienes than their aspirin-tolerant counterparts. We hypothesized that the latter effect reflects elevated expression of the cysteinyl leukotriene receptor CysLT1 on inflammatory cells in the target organ and that its (...) expression is down-regulated by aspirin desensitization.We obtained nasal-biopsy specimens from 22 aspirin-sensitive and 12 non-aspirin-sensitive patients with chronic rhinosinusitis and nasal polyps. Additional specimens were then obtained from subgroups of the aspirin-sensitive patients after intranasal application of lysine aspirin or placebo for two weeks (five and four patients, respectively) or for six months (five and four patients, respectively). The numbers of leukocytes expressing the CysLT1
Aspirin and mortality from coronary bypass surgery. There is no therapy known to reduce the risk of complications or death after coronary bypass surgery. Because platelet activation constitutes a pivotal mechanism for injury in patients with atherosclerosis, we assessed whether early treatment with aspirin could improve survival after coronary bypass surgery.At 70 centers in 17 countries, we prospectively studied 5065 patients undergoing coronary bypass surgery, of whom 5022 survived the first (...) 48 hours after surgery. We gathered data on 7500 variables per patient and adjudicated outcomes centrally. The primary focus was to discern the relation between early aspirin use and fatal and nonfatal outcomes.During hospitalization, 164 patients died (3.2 percent), and 812 others (16.0 percent) had nonfatal cardiac, cerebral, renal, or gastrointestinal ischemic complications. Among patients who received aspirin (up to 650 mg) within 48 hours after revascularization, subsequent mortality was 1.3
Cost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart disease. Both aspirin and clopidogrel reduce the rate of cardiovascular events in patients with coronary heart disease. We estimated the cost effectiveness of the increased use of aspirin, clopidogrel, or both for secondary prevention in patients with coronary heart disease.We used the Coronary Heart Disease Policy Model, a computer simulation of the U.S. population, to estimate the incremental cost (...) effectiveness (in dollars per quality-adjusted years of life gained) of four strategies in patients over 35 years of age with coronary disease from 2003 to 2027: aspirin for all eligible patients (i.e., those who were not allergic to or intolerant of aspirin), aspirin for all eligible patients plus clopidogrel for patients who were ineligible for aspirin, clopidogrel for all patients, and the combination of aspirin for all eligible patients plus clopidogrel for all patients.The extension of aspirin therapy
Aspirin for the primary prevention of cardiovascular events: recommendation and rationale. This statement summarizes the recommendation of the third U.S. Preventive Services Task Force (USPSTF) for aspirin for the primary prevention of cardiovascular events, as well as the supporting scientific evidence. The complete information on which this statement is based, including evidence tables and references, can be found in a companion article in this issue. Copies of this document, the summary
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
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