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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
Single dose oral aspirin for acute pain. Aspirin has been known to be an effective analgesic for many years and is commonly used throughout the world for many different pain conditions. It is important for both prescribers and patients to have the best possible information about the efficacy and safety of analgesics, and this need is reflected in patient surveys which show that postoperative pain is often poorly managed. We also need to benchmark relative efficacy and safety of current (...) analgesics so that we can compare them with new analgesics.To quantitatively assess the analgesic efficacy and adverse effects of a single-dose of aspirin in acute pain of moderate to severe intensity.Randomised trials were identified by searching Medline (1966 to March 1998), Embase (1980 to January 1998), the Cochrane Library (Issue 1,1998) and the Oxford Pain Relief Database (1950 to 1994).The inclusion criteria used were: full journal publication, postoperative pain or a mixture of postoperative
Non-aspirin, non-steroidal anti-inflammatory drugs for osteoarthritis of the knee. To determine whether there is a difference in the relative efficacy of individual non-steroidal anti-inflammatory drugs (NSAIDs) when used in the management of osteoarthritis (OA) of the knee.We searched Medline (1966-1995) and Bids Embase (Jan-Dec, 1980-1995). The searches were limited to publications in the English language, and were last perfomed in November 1996. We used modified Cochrane Collaboration search (...) strategy to identify all randomised controlled trials. The MeSH heading osteoarthritis was combined with the generic names of the 17 non-aspirin NSAIDs licensed in the UK for the management of OA in general practice. The search of Embase used the term "osteoarthritis" if present in the abstract, title or keywords, and was combined with the generic names of the 17 non-aspirin NSAIDs, only if they were mentioned in the title, abstract or keywords.All double blind, randomised controlled trials
Thienopyridine derivatives (ticlopidine, clopidogrel) versus aspirin for preventing stroke and other serious vascular events in high vascular risk patients. The most widely studied and prescribed antiplatelet agent for the prevention of stroke and other serious vascular events among high vascular risk patients is aspirin. Aspirin inhibits platelet activation by inhibiting platelet cyclooxygenase and thromboxane production, and reduces the odds of a serious vascular event by about a quarter (...) . The thienopyridines (ticlopidine and clopidogrel) inhibit platelet activation by a different mechanism to aspirin (blocking the ADP receptor on platelets), and so may be more effective than aspirin.The objective of this review was to determine the effectiveness and safety of thienopyridine derivatives (ticlopidine and clopidogrel) versus aspirin for the prevention of serious vascular events (stroke, myocardial infarction (MI) or vascular death) in patients at high risk of such events, and specifically in patients
Analgesia and non-aspirin, non-steroidal anti-inflammatory drugs for osteoarthritis of the hip. To review all randomized trials of analgesics and anti-inflammatory therapy in osteoarthritis (OA) of the hip. To determine which non-steroidal, anti-inflammatory drug (NSAID) is the most effective, and which NSAID is the most toxic.We searched the Cochrane Musculoskeletal Group's trials register, the Cochrane Controlled Trials Register and Medline up to August 1994. Reference lists of all trials
Comparison of sibrafiban with aspirin for prevention of cardiovascular events after acute coronary syndromes: a randomised trial. The SYMPHONY Investigators. Sibrafiban versus Aspirin to Yield Maximum Protection from Ischemic Heart Events Post-acute Coron Aspirin lowers risks of death and myocardial infarction in patients with acute coronary syndromes. Intravenous glycoprotein IIb/IIIa receptor antagonists further reduce the rates of ischaemic events in these patients, but the efficacy of long (...) -term oral glycoprotein IIb/IIIa receptor blockade has not been established. We tested whether the oral glycoprotein IIb/IIIa receptor antagonist sibrafiban would prevent more cardiovascular events than aspirin, when given within 7 days of, and sustained for 90 days after, an acute coronary syndrome event.9233 patients who had stabilised after an acute coronary syndrome event were randomly assigned aspirin (80 mg orally twice daily) or low-dose or high-dose sibrafiban. Sibrafiban doses (3.0 mg, 4.5
2000LancetControlled trial quality: predicted high
Efficacy of oral anticoagulants compared with aspirin after infrainguinal bypass surgery (The Dutch Bypass Oral Anticoagulants or Aspirin Study): a randomised trial. Oral anticoagulants and aspirin are antithrombotic drugs that are commonly used in patients with vascular disease. We investigated whether either of these treatments prevented more effectively than the other bypass complications after infrainguinal bypass surgery.We did a multicentre, randomised, open trial. 2690 patients who had (...) undergone infrainguinal grafting were randomly assigned oral anticoagulants (target international normalised ratio 3.0-4.5, n=1339) or aspirin (80 mg daily, n=1351). We followed up patients for a mean of 21 months. The primary outcome was graft occlusion.308 graft occlusions occurred in the oral-anticoagulants group compared with 322 in the aspirin group (hazard ratio 0.95 [95% CI 0.82-1.11]), which suggested no overall advantage for either treatment. Oral anticoagulants were beneficial in patients
2000LancetControlled trial quality: predicted high
Aspirin 25mg/extended release dipyridamole 200mg Aspirin 25mg/extended release dipyridamole 200mg Aspirin 25mg/extended release dipyridamole 200mg Sangha K Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Sangha K. Aspirin 25mg/extended release dipyridamole 200mg. University HealthSystem Consortium (UHC). Drug Monograph. 2000 Authors' objectives The UHC Drug (...) their relative advantages, and they address issues concerning therapeutic interchange. Each monograph includes comprehensive information from the primary literature and provides recommendations for appropriate use. Project page URL Indexing Status Subject indexing assigned by CRD MeSH Aspirin; Dipyridamole Language Published English Country of organisation United States Address for correspondence University HealthSystem Consortium, 2001 Spring Rd., Suite 700, Oak Brook, IL 60523 USA. Tel: 630-954-1700; Fax
Determination of who may derive most benefit from aspirin in primary prevention: subgroup results from a randomised controlled trial. To determine which groups of patients may derive particular benefit or experience harm from the use of low dose aspirin for the primary prevention of coronary heart disease.Randomised controlled trial.108 group practices in the Medical Research Council's general practice research framework who were taking part in the thrombosis prevention trial.5499 men aged (...) between 45 and 69 years at entry who were at increased risk of coronary heart disease.Myocardial infarction, coronary death, and stroke.Aspirin reduced coronary events by 20%. This benefit, mainly for non-fatal events, was significantly greater the lower the systolic blood pressure at entry (interaction P=0.0015), the relative risk at pressures 130 mm Hg being 0.55 compared with 0.94 at pressures >145 mm Hg. Aspirin also reduced strokes at low but not high pressures, the relative risks being 0.41
Low molecular-weight heparin versus aspirin in patients with acute ischaemic stroke and atrial fibrillation: a double-blind randomised study. HAEST Study Group. Heparin in Acute Embolic Stroke Trial. Patients with acute ischaemic stroke and atrial fibrillation have an increased risk of early stroke recurrence, and anticoagulant treatment with heparins has been widely advocated, despite missing data on the balance of risk and benefit.Heparin in Acute Embolic Stroke Trial (HAEST (...) ) was a multicentre, randomised, double-blind, and double-dummy trial on the effect of low-molecular-weight heparin (LMWH, dalteparin 100 IU/kg subcutaneously twice a day) or aspirin (160 mg every day) for the treatment of 449 patients with acute ischaemic stroke and atrial fibrillation. The primary aim was to test whether treatment with LMWH, started within 30 h of stroke onset, is superior to aspirin for the prevention of recurrent stroke during the first 14 days.The frequency of recurrent ischaemic stroke
2000LancetControlled trial quality: predicted high
Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Previous trials of antiplatelet therapy for the prevention of venous thromboembolism have individually been inconclusive, but a meta-analysis of their results indicated reductions in the risks of deep-vein thrombosis and of pulmonary embolism in various high-risk groups. The aim of this large randomised placebo-controlled trial was to confirm or refute these apparent (...) benefits.During 1992-1998, 148 hospitals in Australia, New Zealand, South Africa, Sweden and the UK randomised 13,356 patients undergoing surgery for hip fracture, and 22 hospitals in New Zealand randomised a further 4088 patients undergoing elective arthroplasty. Study treatment was 160 mg daily aspirin or placebo, started preoperatively and continued for 35 days. Patients received any other thromboprophylaxis thought necessary. Follow-up was of mortality and of in-hospital morbidity up to day 35.Among
2000LancetControlled trial quality: predicted high
details Shah H, Gondek K. Aspirin plus extended-release dipyridamole or clopidogrel compared with aspirin monotherapy for the prevention of recurrent ischemic stroke: a cost-effectiveness analysis. Clinical Therapeutics 2000; 22(3): 362-370 PubMedID DOI Other publications of related interest Diener HC, Cunha L, Forbes C, et al. European Stroke Prevention Study 2. Dipyridamole and acetylsalicylicacid in the secondary prevention of stroke. Journal of the Neurological Sciences 1996;143:1-13. CAPRIE (...) mg/day), and aspirin (ASA; 50 mg/day) combined with modified-release dipyridamole (MRD; 400 mg/day). Type of intervention Secondary prevention. Economic study type Cost-effectiveness analysis. Study population The study population consisted of a hypothetical cohort of patients who had survived an initial ischaemic stroke. Setting The setting was secondary care. The economic analysis was carried out in the USA. Dates to which data relate The effectiveness data for clopidogrel and ASA-MRD related
authors independently searched MEDLINE and EMBASE from 1990 to 1999 using the free text terms: 'aspirin' or 'acetylsalicylic*', or 'salicylic*'. The authors also selected trials from a list of 200 antiplatelet studies identified in a previous systematic review (see Other Publications of Related Interest), and manually checked the reference lists of retrieved studies. No language restrictions were reported. Study selection Study designs of evaluations included in the review Randomised controlled trials (...) Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis Derry S, Loke Y K Authors' objectives To assess the incidence of gastrointestinal haemorrhage associated with long-term aspirin therapy, and to determine the effect of dose reduction and formulation on the incidence of such haemorrhage. Searching Two
[Prevention of vascular complications after cerebral ischemia of arterial origin. European Stroke and Australian Stroke Prevention in Reversible Ischemia Trial (ESPRIT): moderated coagulation, aspirin-dipyridamole combination or aspirin alone?]. 10365408 1999 07 09 2018 06 12 0248-8663 20 5 1999 May La Revue de medecine interne Rev Med Interne [Prevention of vascular complications after cerebral ischemia of arterial origin. European Stroke and Australian Stroke Prevention in Reversible Ischemia (...) Trial (ESPRIT): moderated coagulation, aspirin-dipyridamole combination or aspirin alone?]. 397-9 De Schryver E L EL Trial Bureau Neurologie, Academisch Ziekenhuis Utrecht. Gorter J W JW Algra A A van Gijn J J fre Clinical Trial Comparative Study Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't Prévention des complications vasculaires après ischémie cérébrale d'origine artérielle. Etude ESPRIT: anticoagulation modérée, association aspirine-dipyridamole
Primary prevention of arterial thromboembolism in non-rheumatic atrial fibrillation in primary care: randomised controlled trial comparing two intensities of coumarin with aspirin. To investigate the effectiveness of aspirin and coumarin in preventing thromboembolism in patients with non-rheumatic atrial fibrillation in general practice.Randomised controlled trial.729 patients aged >/=60 years with atrial fibrillation, recruited in general practice, who had no established indication (...) for coumarin. Mean age was 75 years and mean follow up 2. 7 years.Primary care in the Netherlands.Patients eligible for standard intensity coumarin (international normalised ratio 2.5-3.5) were randomly assigned to standard anticoagulation, very low intensity coumarin (international normalised ratio 1.1-1.6), or aspirin (150 mg/day) (stratum 1). Patients ineligible for standard anticoagulation were randomly assigned to low anticoagulation or aspirin (stratum 2).Stroke, systemic embolism, major haemorrhage
Low-dose and high-dose acetylsalicylicacid for patients undergoing carotid endarterectomy: a randomised controlled trial. ASA and Carotid Endarterectomy (ACE) Trial Collaborators. Endarterectomy benefits certain patients with carotid stenosis, but benefits are lessened by perioperative surgical risk. Acetylsalicylicacid lowers the risk of stroke in patients who have experienced transient ischaemic attack and stroke. We investigated appropriate doses and the role of acetylsalicylicacid (...) in patients undergoing carotid endarterectomy.In a randomised, double-blind, controlled trial, 2849 patients scheduled for endarterectomy were randomly assigned 81 mg (n=709), 325 mg (n=708), 650 mg (n=715), or 1300 mg (n=717) acetylsalicylicacid daily, started before surgery and continued for 3 months. We recorded occurrences of stroke, myocardial infarction, and death. We compared patients on the two higher doses of acetylsalicylicacid with patients on the two lower doses.Surgery was cancelled in 45
1999LancetControlled trial quality: predicted high
A metaregression analysis of the dose-response effect of aspirin on stroke A metaregression analysis of the dose-response effect of aspirin on stroke A metaregression analysis of the dose-response effect of aspirin on stroke Johnson E S, Lanes S F, Wentworth C E, Satterfield M H, Abede B L, Dicker L W Authors' objectives To assess the effect of aspirin dose on the risk of stroke. Searching The authors searched the MEDLINE electronic database (dates and search terms not stated). The authors also (...) searched reference lists of retrieved articles for additional relevant studies. The search was limited to studies published prior to April 30, 1996. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) which were placebo-controlled and included an aspirin-only treatment arm. Included studies also had to report the occurrence of stroke alone. Follow-up ranged from 24 to 48 months (average 32 months). Specific interventions included in the review Aspirin
after infrainguinal bypass surgery Tangelder M J, Lawson J A, Algra A, Eikelboom B C Authors' objectives To determine the efficacy of antiplatelet therapy and oral anticoagulants in maintaining graft patency and preventing ischemic complications in patients after infrainguinal bypass surgery. Searching MEDLINE was searched from 1966 onwards using the keywords 'aspirin', 'acetylsalicylicacid', 'antiplatelet', '(oral) anticoagulants', 'anticoagulation', 'phenprocoumon', 'warfarin', 'peripheral (...) Systematic review of randomized controlled trials of aspirin and oral anticoagulants in the prevention of graft occlusion and ischemic events after infrainguinal bypass surgery Systematic review of randomized controlled trials of aspirin and oral anticoagulants in the prevention of graft occlusion and ischemic events after infrainguinal bypass surgery Systematic review of randomized controlled trials of aspirin and oral anticoagulants in the prevention of graft occlusion and ischemic events
Cost-effectiveness analysis of antiplatelet therapy in the prevention of recurrent stroke in the UK: aspirin, dipyridamole and aspirin-dipyridamole Cost-effectiveness analysis of antiplatelet therapy in the prevention of recurrent stroke in the UK: aspirin, dipyridamole and aspirin-dipyridamole Cost-effectiveness analysis of antiplatelet therapy in the prevention of recurrent stroke in the UK: aspirin, dipyridamole and aspirin-dipyridamole Chambers M, Hutton J, Gladman J 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 antiplatelet therapies, specifically aspirin, dipyridamole and a combination of the two, in the prevention of recurrent stroke, myocardial infarction and other vascular events in patients who have
Increased risk of intracranial hemorrhage when aspirin is combined with warfarin: a meta-analysis and hypothesis 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.
Thrombosis prevention trial: randomised trial of low-intensity oral anticoagulation with warfarin and low-dose aspirin in the primary prevention of ischaemic heart disease in men at increased risk. The Medical Research Council's General Practice Research We aimed to evaluate low intensity oral anticoagulation with warfarin and low-dose aspirin in the primary prevention of ischaemic heart disease (IHD).5499 men aged between 45 years and 69 years at high risk of IHD were recruited from 108 (...) practices in the UK that belong to the Medical Research Council's General Practice Research Framework. Initially, warfarin or placebo was randomly allocated to 1427 men; 1013 of these men later moved to a factorial stage of the trial, retaining their warfarin or placebo warfarin allocation and adding randomly allocated active or placebo aspirin. Another 4072 men entered directly into the factorial stage making a total of 5085 men. The four factorial treatment groups were: active warfarin and active
1998LancetControlled trial quality: predicted high