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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
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
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
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
Low-dose aspirin to prevent preeclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Whether low-dose aspirin prevents preeclampsia is unclear. It is not recommended as prophylaxis in women at low risk for preeclampsia but may reduce the incidence of the disease in women at high risk.We conducted a double-blind, randomized, placebo-controlled trial in four groups of pregnant women at high risk for preeclampsia (...) , including 471 women with pregestational insulin-treated diabetes mellitus, 774 women with chronic hypertension, 688 women with multifetal gestations, and 606 women who had had preeclampsia during a previous pregnancy. The women were enrolled between gestational weeks 13 and 26 and received either 60 mg of aspirin or placebo daily.Outcome data were obtained on all but 36 of the 2539 women who entered the study. The incidence of preeclampsia was similar in the 1254 women in the aspirin group and the 1249
A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina. Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Study Investigators. Activation of platelets is central to the pathophysiology of unstable angina. We studied whether inhibition of the final common pathway for platelet aggregation with tirofiban, a nonpeptide glycoprotein IIb/IIIa receptor antagonist, would improve clinical outcome in this condition.In a double-blind study, we randomly (...) assigned 3232 patients who were already receiving aspirin to additional treatment with intravenous tirofiban for 48 hours. The primary end point was a composite of death, myocardial infarction, or refractory ischemia at 48 hours.The incidence of the composite end point was 32 percent lower at 48 hours in the group that received tirofiban (3.8 percent, vs. 5.6 percent with heparin; risk ratio, 0.67; 95 percent confidence interval, 0.48 to 0.92; P=0.01). Percutaneous revascularization was performed
ISIS-2: 10 year survival among patients with suspected acute myocardial infarction in randomised comparison of intravenous streptokinase, oral aspirin, both, or neither. The ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. To assess effects of intravenous streptokinase, one month of oral aspirin, or both, on long term survival after suspected acute myocardial infarction.Randomised, "2 x 2 factorial," placebo controlled trial.417 hospitals in 16 countries.17 187 (...) patients with suspected acute myocardial infarction randomised between March 1985 and December 1987. Follow up of vital status complete to at least 1 January 1990 for 95% of all patients and to mid-1997 for the 6213 patients in United Kingdom.Intravenous streptokinase (1.5 MU in 1 hour) and oral aspirin (162 mg daily for 1 month) versus matching placebos.Mortality from all causes during up to 10 years' follow up, with subgroup analyses based on 4 year follow up.After randomisation, 1841 deaths were
Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Despite treatment, there is often a higher incidence of cardiovascular complications in patients with hypertension than in normotensive individuals. Inadequate reduction of their blood pressure is a likely cause, but the optimum target blood pressure is not known. The impact of acetylsalicylicacid (...) (aspirin) has never been investigated in patients with hypertension. We aimed to assess the optimum target diastolic blood pressure and the potential benefit of a low dose of acetylsalicylicacid in the treatment of hypertension.18790 patients, from 26 countries, aged 50-80 years (mean 61.5 years) with hypertension and diastolic blood pressure between 100 mm Hg and 115 mm Hg (mean 105 mm Hg) were randomly assigned a target diastolic blood pressure. 6264 patients were allocated to the target pressure
1998LancetControlled trial quality: predicted high
Aspirin and risk of hemorrhagic stroke: a meta-analysis of randomized controlled trials. Aspirin has been widely used to prevent myocardial infarction and ischemic stroke but some studies have suggested it increases risk of hemorrhagic stroke.To estimate the risk of hemorrhagic stroke associated with aspirin treatment.Studies were retrieved using MEDLINE (search terms, aspirin, cerebrovascular disorders, and stroke), bibliographies of the articles retrieved, and the authors' reference files.All (...) trials published in English-language journals before July 1997 in which participants were randomized to aspirin or a control treatment for at least 1 month and in which the incidence of stroke subtype was reported.Information on country of origin, sample size, duration, study design, aspirin dosage, participant characteristics, and outcomes was abstracted independently by 2 authors who used a standardized protocol.Data from 16 trials with 55462 participants and 108 hemorrhagic stroke cases were
of combination antithrombic therapy with warfarin (or related coumarins) and acetylsalicylicacid (ASA), versus monotherapy with either agent. Searching MEDLINE was searched from 1966 to February 1998 using the following search terms: 'warfarin', 'coumarin', 'ASA' and 'acetylsalicylicacid', 'anticoagulation', 'combination', 'combined', 'atrial fibrillation', 'myocardial infarction' and 'mechanical waves'. The references of identified articles were also examined. Study selection Study designs of evaluations (...) The efficacy and safety of combination warfarin and ASA therapy: a systematic review of the literature and update of guidelines The efficacy and safety of combination warfarin and ASA therapy: a systematic review of the literature and update of guidelines The efficacy and safety of combination warfarin and ASA therapy: a systematic review of the literature and update of guidelines Loewen P, Sunderji R, Gin K Authors' objectives To review the evidence regarding the efficacy and safety
A cost-effectiveness analysis of aspirin versus oral anticoagulants after acute myocardial infarction in Italy: equivalence of costs as a possible case for oral anticoagulants A cost-effectiveness analysis of aspirin versus oral anticoagulants after acute myocardial infarction in Italy: equivalence of costs as a possible case for oral anticoagulants A cost-effectiveness analysis of aspirin versus oral anticoagulants after acute myocardial infarction in Italy: equivalence of costs as a possible (...) case for oral anticoagulants Gianetti J, Gensini G, De Caterina R 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 Aspirin (antiplatelet) and warfarin (anticoagulant) for the prevention of coronary artery disease after acute
and the conclusions drawn. Health technology Low-dose of acetylsalicylicacid (ASA) and sustained-release dipyridamole (DP) in the prevention of recurrent stroke. Type of intervention Secondary prevention. Economic study type Cost-effectiveness analysis. Study population Patients who had suffered a previous stroke. No further details were given. Setting Hospital. The economic study was performed in Belgium. Dates to which data relate The effectiveness data related to a study performed between 1981 and 1986 (...) prevention strategies other than those implying the use of ASA and DP drugs should also be considered for an exhaustive comparison. Source of funding None stated. Bibliographic details Kurz X, Annemans L, Dresse A. Association AAS-dypiridamole (Asasantine) dans la prevention des recidives d'AVC (analyse cout-efficacite). [An acetylsalicylicacid-dipyridamole combination (Asasantine) in the prevention of the recurrence of cerebrovascular accidents (a cost-effectiveness analysis)] Revue Medicale de Liege