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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 and risk of hemorrhagic stroke: a meta-analysis of randomized controlled trials Aspirin and risk of hemorrhagic stroke: a meta-analysis of randomized controlled trials Aspirin and risk of hemorrhagic stroke: a meta-analysis of randomized controlled trials He J, Whelton P K, Vu B, Klag M J Authors' objectives To estimate the risk of haemorrhagic stroke associated with aspirin treatment. Searching MEDLINE was searched from 1966 through June 1997 for articles published in the English (...) language using the keywords 'aspirin' and 'cerebrovascular disorders', as well as 'stroke'. Articles retrieved were those identified in the database as clinical trials on human subjects. A manual search was preformed using the authors' reference files and reference lists from original communications and review articles. Study selection Study designs of evaluations included in the review Studies were included if they fulfilled the following criteria: random allocation to aspirin or concurrent control
Aspirin for the secondary prophylaxis of vascular disease in primary care Aspirin for the secondary prophylaxis of vascular disease in primary care Aspirin for the secondary prophylaxis of vascular disease in primary care University of Newcastle upon Tyne. Centre for Health Services Research; University of York. Centre for Health Economics Authors' objectives To provide evidence linked recommendations for general practitioners on the use of aspirin for the secondary prophylaxis of nonfatal (...) reviews, meta-analyses, randomised trials, quality of life studies and economic studies with follow-up ranging from 2 to 4 years. Specific interventions included in the review Aspirin (75 to 150 mg/day) and other antiplatelet therapies. Participants included in the review Patients at risk of cardiovascular disease or stroke including actual and suspected acute myocardial infarction (MI), previous MI, stable angina, unstable angina, past history of stoke or transient ischaemic attack, and intermittent
Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. Inflammation may be important in the pathogenesis of atherothrombosis. We studied whether inflammation increases the risk of a first thrombotic event and whether treatment with aspirin decreases the risk.We measured plasma C-reactive protein, a marker for systemic inflammation, in 543 apparently healthy men participating in the Physicians' Health Study in whom myocardial infarction, stroke, or venous (...) thrombosis subsequently developed, and in 543 study participants who did not report vascular disease during a follow-up period exceeding eight years. Subjects were randomly assigned to receive aspirin or placebo at the beginning of the trial.Base-line plasma C-reactive protein concentrations were higher among men who went on to have myocardial infarction (1.51 vs. 1.13 mg per liter, P<0.001) or ischemic stroke (1.38 vs. 1.13 mg per liter, P=0.02), but not venous thrombosis (1.26 vs. 1.13 mg per liter, P
Randomised controlled trial of aspirin and aspirin plus heparin in pregnant women with recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies) To determine whether treatment with low dose aspirin and heparin leads to a higher rate of live births than that achieved with low dose aspirin alone in women with a history of recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies), lupus anticoagulant, and cardiolipin (...) antibodies (or anticardiolipin antibodies).Randomised controlled trial.Specialist clinic for recurrent miscarriages.90 women (median age 33 (range 22-43)) with a history of recurrent miscarriage (median number 4 (range 3-15)) and persistently positive results for phospholipid antibodies.Either low dose aspirin (75 mg daily) or low dose aspirin and 5000 U of unfractionated heparin subcutaneously 12 hourly. All women started treatment with low dose aspirin when they had a positive urine pregnancy test
The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. International Stroke Trial Collaborative Group. Only a few small trials have compared antithrombotic therapy (antiplatelet or anticoagulant agents) versus control in acute ischaemic stroke, and none has been large enough to provide reliable evidence on safety or efficacy.The International Stroke Trial (IST) was a large, randomised, open (...) trial of up to 14 days of antithrombotic therapy started as soon as possible after stroke onset. The aim was to provide reliable evidence on the safety and efficacy of aspirin and of subcutaneous heparin. Half the patients were allocated unfractionated heparin (5000 or 12,500 IU bd [twice daily]), and half were allocated "avoid heparin"; and, in a factorial design, half were allocated aspirin 300 mg daily and half "avoid aspirin". The primary outcomes were death within 14 days and death
1997LancetControlled trial quality: predicted high
Randomised double-blind trial of fixed low-dose warfarin with aspirin after myocardial infarction. Coumadin Aspirin Reinfarction Study (CARS) Investigators. Antiplatelet therapy with aspirin and systematic anticoagulation with warfarin reduce cardiovascular morbidity and mortality after myocardial infarction when given alone. In the Coumadin Aspirin Reinfarction Study (CARS), we aimed to find out whether a combination of low-dose warfarin and low-dose aspirin would give superior results (...) to standard aspirin monotherapy without excessive bleeding risk.We used a randomised double-blind study design. At 293 sites, we randomly assigned 8803 patients who had had myocardial infarction, treatment with 160 mg aspirin, 3 mg warfarin with 80 mg aspirin, or 1 mg warfarin with 80 mg aspirin. Patients took a single tablet daily, and attended for prothrombin time (PT) measurements at weeks 1, 2, 3, 4, 6, and 12, and then every 3 months. Patients were followed up for a maximum of 33 months (median 14
1997LancetControlled trial quality: predicted high
Randomised controlled trial of ketanserin and aspirin in prevention of pre-eclampsia. Pre-eclampsia is associated with extensive endothelial-cell damage and platelet activation, resulting in lower production of vasodilator prostaglandins and increased release of the vasoconstrictors thromboxane A2 and serotonin. Damage to endothelial-cell serotonin-1 receptors leaves vasoconstriction and platelet aggregation mediated by serotonin-2 receptors unopposed. We investigated the role of ketanserin (...) , a selective serotonin-2-receptor antagonist, in lowering the rate of pre-eclampsia among pregnant women with mild to moderate hypertension.We recruited 138 pregnant women into a double-blind, randomised, placebo-controlled trial. They had diastolic blood pressure persistently more than 80 mm Hg before 20 weeks' gestation. 69 women received ketanserin and 69 received placebo. Both groups also received aspirin. Patients were initially given two tablets daily, increased to four tablets daily in diastolic
1997LancetControlled trial quality: predicted high
CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group. Aspirin is effective in the treatment of acute myocardial infarction and in the long-term prevention of serious vascular events in survivors of stroke and myocardial infarction. There is, however, no reliable evidence on the effectiveness of early aspirin use in acute ischaemic stroke.The Chinese Acute Stroke Trial (CAST (...) ) was a large randomised, placebo-controlled trial of the effects in hospital of aspirin treatment (160 mg/day) started within 48 h of the onset of suspected acute ischaemic stroke and continued in hospital for up to 4 weeks. The primary endpoints were death from any cause during the 4-week treatment period and death or dependence at discharge, and the analyses were by intention to treat. 21,106 patients with acute ischaemic stroke were enrolled in 413 Chinese hospitals at a mean of 25 h after the onset
1997LancetControlled trial quality: predicted high
Prednisone and aspirin in women with autoantibodies and unexplained recurrent fetal loss. Recurrent fetal loss has been well described in women with antiphospholipid antibodies. Such women also often have other autoantibodies commonly found in patients with systemic lupus erythematosus. Treating them with prednisone and aspirin may reduce the risk of fetal loss.We screened 773 nonpregnant women who had the unexplained loss of at least two fetuses for antinuclear, anti-DNA, antilymphocyte (...) , and anticardiolipin antibodies and for the lupus anticoagulant. Of 385 women with at least one autoantibody, 202 who later became pregnant were randomly assigned in equal numbers to receive either prednisone (0.5 to 0.8 mg per kilogram of body weight per day) and aspirin (100 mg per day) or placebo for the duration of the pregnancy. The women were stratified according to age (18 to 34 years or 35 to 39 years) and the week of gestation at which the previous fetal losses had occurred (< or = 12 or > 12 weeks
in the primary prevention of cardiovascular disease and colon cancer. Alberta Heritage Foundation for Medical Research (AHFMR) 1997: 25 Authors' objectives To assess the evidence of effectiveness and safety in the prophylactic use of acetylsalicylicacid in the primary prevention of myocardial infarction, stroke and colon cancer. Authors' conclusions There is insufficient evidence to support the prophylactic use of ASA in the general population to reduce the risk of myocardial infarction, stroke and colon (...) cancer. ASA prophylaxis is effective in various groups who are at high risk for cardiovascular disease. However, more effective treatments are available for some conditions, such as atrial fibrillation, which are associated with a high risk of stroke, though such treatments are associated with a higher risk of complications. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Aspirin /therapeutic use; Cerebrovascular Disorders; Colorectal Neoplasms; Myocardial Infarction
Do codeine and caffeine enhance the analgesic effect of aspirin: a systematic overview Do codeine and caffeine enhance the analgesic effect of aspirin: a systematic overview Do codeine and caffeine enhance the analgesic effect of aspirin: a systematic overview Zhang W Y, Li Wan Po A Authors' objectives To assess whether codeine and caffeine enhance the analgesic effect of aspirin in post-operative pain. Searching Computerised searches of MEDLINE and BIDS (EMBASE and ISI databases) were (...) were included. The observation period in the trials ranged from 2 to 12 hours. Studies were excluded on the basis of the following: relevant data were not extractable; there was self-controlled dose adjustment; syrup or buffered formulations were used; or the report of the trial was unobtainable. Abstracts and reports from multi-dose trials were also excluded. Specific interventions included in the review Oral formulations of aspirin, aspirin and codeine, aspirin and caffeine, and placebo
Combined aspirin and metoclopramide in the acute treatment of migraine attacks: a review Combined aspirin and metoclopramide in the acute treatment of migraine attacks: a review Combined aspirin and metoclopramide in the acute treatment of migraine attacks: a review Chabriat H, Danchot J, Hugues F C, Joire J E Authors' objectives To review all the trials evaluating the efficacy of combined aspirin and metoclopramide (CAM) in the acute treatment of migraine attacks. Searching MEDLINE (...) and Excerpta Medica were searched from 1975 to 1996. No search terms were provided. Study selection Study designs of evaluations included in the review Both open and double-blind trials were included in the review. No details were provided of the method used to allocate the patients to the groups. Uncontrolled studies were also included. Specific interventions included in the review The combination of oral aspirin (in doses ranging from 650 to 900 mg) and oral metoclopramide (10 mg per dose) was compared
=0.966, p=0.0017). The corresponding figures at the convalescent stage were 17.6, 13.5, 9.7, 6.3 and 3.8%, respectively, (correlation, adjusted R2=0.993, p=0.0602). The chi-squared analysis between the moderate- and high-dose aspirin groups at any IVGG dose during the subacute stage showed no significant differences. The convalescent stage curves were virtually superimposable, demonstrating that the IVGG effect on CAA is independent of salicylate dose. Authors' conclusions Two g/kg IVGG combined (...) Prevalence of coronary artery abnormalities in Kawasaki disease is highly dependent on gamma globulin dose but independent of salicylate dose Prevalence of coronary artery abnormalities in Kawasaki disease is highly dependent on gamma globulin dose but independent of salicylate dose Prevalence of coronary artery abnormalities in Kawasaki disease is highly dependent on gamma globulin dose but independent of salicylate dose Terai M, Shulman S T Authors' objectives To determine the effect
medical databases including MEDLINE (from 1964 onwards) and EMBASE (from 1974 onwards) were searched using the terms 'acetylsalicylicacid', 'aspirin', 'pregnancy', 'randomised' and 'meta-analysis'. References from retrieved reports and review articles were also examined. Only reports published in the English language were considered. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) of aspirin alone or in combination with another antiplatelet (...) A meta-analysis of low dose aspirin for the prevention of intrauterine growth retardation A meta-analysis of low dose aspirin for the prevention of intrauterine growth retardation A meta-analysis of low dose aspirin for the prevention of intrauterine growth retardation Leitich H, Egarter C, Husslein P, Kaider A, Schemper M Authors' objectives To determine more precisely the effect of prophylactic low-dose aspirin on intra-uterine growth retardation and perinatal mortality. Searching Eighteen
Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina. A meta-analysis. To estimate the risk of myocardial infarction (MI) and death in patients with unstable angina who are treated with aspirin plus heparin compared with patients treated with aspirin alone.Studies were retrieved using MEDLINE, bibliographies, and consultation with experts.Only published trials that enrolled patients with unstable angina, randomized participants (...) to aspirin plus heparin vs aspirin alone, and reported incidence of myocardial infarction or death were included in the meta-analysis.Patient outcomes including MI or death, recurrent ischemic pain, and major bleeding during randomized treatment; revascularization procedures after randomization; and MI or death during the 2 to 12 weeks following randomization were extracted by 2 authors, 1 of whom was blinded to the journal, institution, and author of each study.Six randomized trials were included
Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation: Stroke Prevention in Atrial Fibrillation III randomised clinical trial. Adjusted-dose warfarin is highly efficacious for prevention of ischaemic stroke in patients with atrial fibrillation (AF). However, this treatment carries a risk of bleeding and the need for frequent medical monitoring. We sought an alternative that would be safer and easier to administer (...) to patients with AF who are at high-risk of thromboembolism.1044 patients with AF and with at least one thromboembolic risk factor (congestive heart failure or left ventricular fractional shortening < or = 25%, previous thromboembolism, systolic blood pressure of more than 160 mm Hg at study enrollment, or being a woman aged over 75 years) were randomly assigned either a combination of low-intensity, fixed-dose warfarin (international normalised ratio [INR] 1.2-1.5 for initial dose adjustment) and aspirin
A comparison of aspirin and anticoagulation following thrombolysis for myocardial infarction (the AFTER study): a multicentre unblinded randomised clinical trial. To compare aspirin with anticoagulation with regard to risk of cardiac death and reinfarction in patients who received anistreplase thrombolysis for myocardial infarction.A multicentre unblinded randomised clinical trial.38 hospitals in six countries.1036 patients who had been treated with anistreplase for myocardial infarction were (...) randomly assigned to either aspirin (150 mg daily) or anticoagulation (intravenous heparin followed by warfarin or other oral anticoagulant). The trial was stopped earlier than originally intended because of the slowing rate of recruitment.Cardiac death or recurrent myocardial infarction at 30 days.After 30 days cardiac death or reinfarction, occurred in 11.0% (57/517) of the patients treated with anticoagulation and 11.2% (58/519) of the patients treated with aspirin (odds ratio 1.02, 95% confidence
A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Many clinical trials have evaluated the benefit of long-term use of antiplatelet drugs in reducing the risk of clinical thrombotic events. Aspirin and ticlopidine have been shown to be effective, but both have potentially serious adverse effects. Clopidogrel, a new thienopyridine derivative similar to ticlopidine, is an inhibitor of platelet aggregation induced (...) by adenosine diphosphate.CAPRIE was a randomised, blinded, international trial designed to assess the relative efficacy of clopidogrel (75 mg once daily) and aspirin (325 mg once daily) in reducing the risk of a composite outcome cluster of ischaemic stroke, myocardial infarction, or vascular death; their relative safety was also assessed. The population studied comprised subgroups of patients with atherosclerotic vascular disease manifested as either recent ischaemic stroke, recent myocardial infarction
1996LancetControlled trial quality: predicted high
Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina: a meta-analysis Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina: a meta-analysis Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina: a meta-analysis Oler A, Whooley M A, Oler J, Grady D Authors' objectives To determine whether treatment (...) with intravenous heparin and aspirin is more effective than treatment with aspirin alone, in preventing myocardial infarction (MI) or death in patients with unstable angina. Searching MEDLINE was searched from January 1966 to September 1995 for articles published in any language using the keywords 'aspirin', 'heparin' and 'unstable angina'. Additonal material was obtained by handsearching of references from identified articles, and by consultation with experts. Study selection Study designs of evaluations
Randomised comparison of subcutaneous heparin, intravenous heparin, and aspirin in unstable angina. Studio Epoorine Sottocutanea nell'Angina Instobile (SESAIR) Refrattorie Group. Intravenous heparin has been used in the control of myocardial ischaemia in patients with unstable angina. We set out to assess the efficacy of subcutaneous heparin in reducing myocardial ischaemia in patients with unstable angina. 343 of 399 patients with unstable angina were monitored for 24 h and 108 were refractory (...) to conventional antianginal treatment and were entered into a randomised multicentre trial. 37 patients were assigned to heparin infusion (partial thromboplastin time 1.5-2 times baseline), 35 to subcutaneous heparin (adjusted dose with partial thromboplastin time 1.5-2 times baseline), and 36 to aspirin (325 mg daily). All had additional conventional antianginal therapy. After the run-in patients were monitored for 3 days. The primary endpoint was reduced myocardial ischaemia assessed by the number