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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
Aspirin for the primary prevention of cardiovascular events Aspirin for the primary prevention of cardiovascular events Aspirin for the primary prevention of cardiovascular events Hayden M, Pignone M, Phillips C, Mulrow 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 Hayden M, Pignone M, Phillips C, Mulrow C. Aspirin for the primary (...) prevention of cardiovascular events. Rockville: Agency for Healthcare Research and Quality (AHRQ). Preventive Services Task Force Systematic Evidence Review. 2002 Authors' objectives To examine the benefits and harms of aspirin chemoprevention. Authors' conclusions Aspirin can prevent myocardial infarctions but increases the risk of gastrointestinal bleeding and appears to increase the risk of hemorrhagic stroke. The net benefit of aspirin increases with increasing cardiovascular risk. The decision about
Summary of the evidence: aspirin for the primary prevention of cardiovascular events Summary of the evidence: aspirin for the primary prevention of cardiovascular events Summary of the evidence: aspirin for the primary prevention of cardiovascular events Hayden M, Pignone M, Phillips C, Mulrow C Authors' objectives To examine the benefits and harms of aspirin for the primary prevention of cardiovascular events in patients without a previous history of cardiovascular disease (CVD). Searching (...) in the trials ranged from 3.6 to 6.8 years. Specific interventions included in the review Studies that compared aspirin with placebo or no aspirin were eligible for inclusion. The included trials used aspirin at a dose of between 75 and 500 mg/day. Four of the included studies also gave participants additional therapies: one study gave beta-carotene to 50% of the participants, one study gave warfarin to its participants, one study gave felodipine with or without an angiotensin-converting enzyme inhibitor
Evaluation of the benefits and risks of low-dose aspirin in the secondary prevention of cardiovascular and cerebrovascular events Evaluation of the benefits and risks of low-dose aspirin in the secondary prevention of cardiovascular and cerebrovascular events Evaluation of the benefits and risks of low-dose aspirin in the secondary prevention of cardiovascular and cerebrovascular events Weisman S M, Graham D Y Authors' objectives To compare the benefit and gastrointestinal risk of low-dose (...) aspirin for the secondary prevention of thromboembolic events. Searching MEDLINE, EMBASE, and Excerpta Medica were searched for reports published after 1970 on aspirin for secondary prevention indications, which have been approved by the U.S. Food and Drug Administration (FDA). These indications are summarised in the FDA's 1998 rule and updated professional labelling for aspirin. Study selection Study designs of evaluations included in the review Randomised, placebo-controlled trials were eligible
Effects of long-term treatment with angiotensin-converting-enzyme inhibitors in the presence or absence of aspirin: a systematic review Effects of long-term treatment with angiotensin-converting-enzyme inhibitors in the presence or absence of aspirin: a systematic review Effects of long-term treatment with angiotensin-converting-enzyme inhibitors in the presence or absence of aspirin: a systematic review Teo K K, Yusuf S, Pfeffer M, Kober L, Hall A, Pogue J, Latini R, Collins R Authors (...) ' objectives To confirm or refute the theory that aspirin alters the effects of angiotensin-converting enzyme (ACE) inhibitor therapy on major clinical outcomes, by conducting a meta-analysis of individual patient data (IPD) from trials in which the patients were randomised to receive ACE inhibitors or placebo, and either took or did not take aspirin at baseline. Searching MEDLINE was searched, although the dates over which the search was conducted were not given. In addition, researchers and colleagues
Aspirin consumption during the first trimester of pregnancy and congenital anomalies: a meta-analysis Aspirin consumption during the first trimester of pregnancy and congenital anomalies: a meta-analysis Aspirin consumption during the first trimester of pregnancy and congenital anomalies: a meta-analysis Kozer E, Nikfar S, Costei A, Boskovic R, Nulman I, Koren G Authors' objectives To determine whether aspirin use during the first trimester of pregnancy is associated with an increased risk (...) . Study selection Study designs of evaluations included in the review Prospective and retrospective controlled studies were eligible for inclusion. Uncontrolled studies, case reports or case series of less than six patients, editorials and reviews were excluded. Specific interventions included in the review Studies of aspirin were eligible for inclusion. The included studies obtained information on aspirin exposure mainly from interviews with mothers; the timing of these ranged from during early
Aspirin prophylaxis in patients at low risk for cardiovascular disease: a systematic review of all-cause mortality Aspirin prophylaxis in patients at low risk for cardiovascular disease: a systematic review of all-cause mortality Aspirin prophylaxis in patients at low risk for cardiovascular disease: a systematic review of all-cause mortality Boltri J M, Akerson M R, Vogel R L Authors' objectives To assess whether aspirin reduces all-cause mortality in low-risk patients. Searching MEDLINE (...) and the Cochrane Library were searched using the terms 'aspirin' or 'antiplatelet therapy' and 'primary prevention' or 'prevention' and 'primary' and 'mortality'. Additional searches were made with 'primary prevention' and 'myocardial infarction' or 'stroke'. No search dates were reported. The Internet was also searched using the same search terms. The authors did not state whether any language restrictions were applied. Study selection Study designs of evaluations included in the review Randomised controlled
Aspirin in diabetic retinopathy: a systematic review Aspirin in diabetic retinopathy: a systematic review Aspirin in diabetic retinopathy: a systematic review Bergerhoff K, Clar C, Richter B Authors' objectives To assess the impact of aspirin alone and in combination with other antiplatelet agents on the progression of diabetic retinopathy. Searching The Cochrane Library (including the Cochrane Controlled Trials Register) and MEDLINE were searched up to 2001. Study selection Study designs (...) of evaluations included in the review Only randomised controlled trials (RCTs) were eligible for inclusion. Specific interventions included in the review Studies of aspirin alone versus placebo, or aspirin in combination with dipyridamole versus placebo, were eligible for inclusion. Aspirin alone was used in two of the included studies, while in one study aspirin alone was compared with aspirin-dipyridamole. The aspirin dosage ranged from 650 to 990 mg/day; the dipyridamole dosage was 225 mg/day. All
Chemoprevention of colorectal cancer by aspirin: a cost-effectiveness analysis Chemoprevention of colorectal cancer by aspirin: a cost-effectiveness analysis Chemoprevention of colorectal cancer by aspirin: a cost-effectiveness analysis Suleiman S, Rex D K, Sonnenberg A 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 Three strategies for the prevention of colorectal cancer (CRC) were examined: colonoscopy (COL) once every 10 years or, in case of adenomatous polyps, every 3 years until polyps were no longer found; chemoprevention (CHE) with 325 mg/day aspirin; and a combination of the first and second strategies (i.e. COL every 10 or 3 years plus 325 mg/day aspirin). Type of intervention Diagnosis and primary prevention
Role of 5-aminosalicylic acid (5-ASA) in treatment of inflammatory bowel disease: a systematic review Role of 5-aminosalicylic acid (5-ASA) in treatment of inflammatory bowel disease: a systematic review Role of 5-aminosalicylic acid (5-ASA) in treatment of inflammatory bowel disease: a systematic review Gisbert J P, Gomollon F, Mate J, Pajares J M Authors' objectives To perform a systematic review of the efficacy of 5-aminosalicylic acid (5-ASA) compounds (oral and topical) in the treatment (...) disease', and any of the following terms: 'mesalamine', 'mesalazine', '5-ASA', '5-aminosalicylic acid'. The references from reviews and meta-analyses on the treatment of IBD with 5-ASA, and from the articles selected for the study, were also examined. Articles published in any language were considered. Study selection Study designs of evaluations included in the review Only randomised controlled trials (RCTs) were eligible for inclusion. Specific interventions included in the review Studies which
of acetylsalicylicacid in the prevention of coronary heart disease] Metaanalisis de la evidencia cientifica sobre la utilidad de la toma esporadica de acido acetilsalicilico en la prevencion de enfermedad coronaria [Meta-analysis of the scientific evidence on the usefulness of sporadic intake of acetylsalicylicacid in the prevention of coronary heart disease] Pueyo G, Elosua R, Marrugat J Authors' objectives To determine whether sporadic intake of aspirin protects against coronary heart disease. Searching (...) . Bibliographic details Pueyo G, Elosua R, Marrugat J. Metaanalisis de la evidencia cientifica sobre la utilidad de la toma esporadica de acido acetilsalicilico en la prevencion de enfermedad coronaria [Meta-analysis of the scientific evidence on the usefulness of sporadic intake of acetylsalicylicacid in the prevention of coronary heart disease] Medicina Clinica 2002; 18(5): 166-169 Indexing Status Subject indexing assigned by NLM MeSH Aspirin /administration & Coronary Disease /prevention & Platelet
Cost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart 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.
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
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
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
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
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
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