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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
Cost-effectiveness of aspirin, celecoxib, and calcium chemoprevention for colorectal cancer Cost-effectiveness of aspirin, celecoxib, and calcium chemoprevention for colorectal cancer Cost-effectiveness of aspirin, celecoxib, and calcium chemoprevention for colorectal cancer Squires H, Tappenden P, Cooper K, Carroll C, Logan R, Hind D 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. CRD summary This study assessed the cost-effectiveness of aspirin, celecoxib, or calcium for the prevention of colorectal cancer, with a screening programme, for the general population or those who had undergone colorectal polypectomy. Calcium chemoprevention was likely to be cost-effective after polypectomy, but the evidence was weak. Aspirin could be cost
Cost-effectiveness comparison of breast cancer screening and vascular event primary prevention with aspirin in Wales Cost-effectiveness comparison of breast cancer screening and vascular event primary prevention with aspirin in Wales Cost-effectiveness comparison of breast cancer screening and vascular event primary prevention with aspirin in Wales Morgan G 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. CRD summary This study assessed the cost-effectiveness of a health education programme plus aspirin for the primary prevention of vascular events in the general population aged 50 years or older, and compared this with the cost-effectiveness of breast cancer screening. The results supported the implementation of an education programme
A multicenter, randomized trial comparing heparin/warfarin and acetylsalicylicacid as primary thromboprophylaxis for 2 years after the Fontan procedure in children PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Aspirin in primary and secondary prevention in elderly adults revisited. Despite the frequency and long duration of aspirin use, its role in primary and secondary prevention in older adults is not well studied. This review takes a critical look at the available literature on aspirin efficacy in elderly adults, and some relevant guidelines for practicing physicians are suggested.
[Aspirin prescription pattern among diabetic patients for prevention of cardiovascular disease] [Aspirin prescription pattern among diabetic patients for prevention of cardiovascular disease] [Aspirin prescription pattern among diabetic patients for prevention of cardiovascular disease] Park BJ, Park YS, Choi NK, Lee YJ, Kim MS, Lee CW, Kang DY, Park SY, Park JE, Lee NR, Shin JY, Sung JM, Kim SM, Yang BR, Kim HM, Ahn HJ, Kim JY, Go YJ 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 Park BJ, Park YS, Choi NK, Lee YJ, Kim MS, Lee CW, Kang DY, Park SY, Park JE, Lee NR, Shin JY, Sung JM, Kim SM, Yang BR, Kim HM, Ahn HJ, Kim JY, Go YJ. [Aspirin prescription pattern among diabetic patients for prevention of cardiovascular disease] Seoul: National Evidence-based Healthcare Collaborating Agency (NECA). NECA-A-11-002. 2012 Authors
ASAS modification of the Berlin algorithm for diagnosing axial spondyloarthritis: results from the SPondyloArthritis Caught Early (SPACE)-cohort and from the Assessment of SpondyloArthritis international Society (ASAS)-cohort To compare the original Berlin algorithm for diagnosing axial Spondyloarthritis (axSpA) with two modifications in the SPondyloArthritis Caught Early (SPACE)-cohort and the Assessment of SpondyloArthritis international Society (ASAS) axSpA criteria validation (ASAS (...) )-cohort.Patients in the SPACE-cohort (back pain ≥3 months, ≤2 years, onset <45 years) and the ASAS-cohort (undiagnosed chronic back pain) were diagnosed according to three algorithms: original (inflammatory back pain (IBP) mandatory), modification 1 (IBP defined by ≥3/5 IBP-features instead of ≥4/5) and modification 2 (IBP deleted as obligatory entry criterion, added as SpA-feature). Diagnosis by rheumatologist, ASAS axSpA criteria and likelihood ratio product were used as external standards to test
Warfarin and aspirin in patients with heart failure and sinus rhythm. It is unknown whether warfarin or aspirin therapy is superior for patients with heart failure who are in sinus rhythm.We designed this trial to determine whether warfarin (with a target international normalized ratio of 2.0 to 3.5) or aspirin (at a dose of 325 mg per day) is a better treatment for patients in sinus rhythm who have a reduced left ventricular ejection fraction (LVEF). We followed 2305 patients for up to 6 years (...) (mean [±SD], 3.5±1.8). The primary outcome was the time to the first event in a composite end point of ischemic stroke, intracerebral hemorrhage, or death from any cause.The rates of the primary outcome were 7.47 events per 100 patient-years in the warfarin group and 7.93 in the aspirin group (hazard ratio with warfarin, 0.93; 95% confidence interval [CI], 0.79 to 1.10; P=0.40). Thus, there was no significant overall difference between the two treatments. In a time-varying analysis, the hazard ratio
Early administration of aspirin in patients treated with alteplase for acute ischaemic stroke: a randomised controlled trial. Thrombolysis with intravenous alteplase is the only approved treatment for acute ischaemic stroke. After alteplase-induced recanalisation, reocclusion occurs in 14-34% of patients, probably because of platelet activation. Early administration of antiplatelet therapy after alteplase could reduce the risk of reocclusion and improve outcome. We compared the effects of early (...) addition of intravenous aspirin to alteplase with standard alteplase without aspirin.In this multicentre, randomised, open-label trial with blind-endpoint assessment, patients with acute ischaemic stroke treated with alteplase were randomly assigned to 300 mg intravenous aspirin within 90 min after start of alteplase treatment or to no additional treatment. In both groups, oral antiplatelet therapy was started 24 h after alteplase treatment. The primary endpoint was favourable outcome, defined
2012LancetControlled trial quality: predicted high
Effects of clopidogrel added to aspirin in patients with recent lacunar stroke. Lacunar infarcts are a frequent type of stroke caused mainly by cerebral small-vessel disease. The effectiveness of antiplatelet therapy for secondary prevention has not been defined.We conducted a double-blind, multicenter trial involving 3020 patients with recent symptomatic lacunar infarcts identified by magnetic resonance imaging. Patients were randomly assigned to receive 75 mg of clopidogrel or placebo daily (...) ; patients in both groups received 325 mg of aspirin daily. The primary outcome was any recurrent stroke, including ischemic stroke and intracranial hemorrhage.The participants had a mean age of 63 years, and 63% were men. After a mean follow-up of 3.4 years, the risk of recurrent stroke was not significantly reduced with aspirin and clopidogrel (dual antiplatelet therapy) (125 strokes; rate, 2.5% per year) as compared with aspirin alone (138 strokes, 2.7% per year) (hazard ratio, 0.92; 95% confidence
Aspirin for preventing the recurrence of venous thromboembolism. About 20% of patients with unprovoked venous thromboembolism have a recurrence within 2 years after the withdrawal of oral anticoagulant therapy. Extending anticoagulation prevents recurrences but is associated with increased bleeding. The benefit of aspirin for the prevention of recurrent venous thromboembolism is unknown.In this multicenter, investigator-initiated, double-blind study, patients with first-ever unprovoked venous (...) thromboembolism who had completed 6 to 18 months of oral anticoagulant treatment were randomly assigned to aspirin, 100 mg daily, or placebo for 2 years, with the option of extending the study treatment. The primary efficacy outcome was recurrence of venous thromboembolism, and major bleeding was the primary safety outcome.Venous thromboembolism recurred in 28 of the 205 patients who received aspirin and in 43 of the 197 patients who received placebo (6.6% vs. 11.2% per year; hazard ratio, 0.58; 95
Low-dose aspirin for preventing recurrent venous thromboembolism. Patients who have had a first episode of unprovoked venous thromboembolism have a high risk of recurrence after anticoagulants are discontinued. Aspirin may be effective in preventing a recurrence of venous thromboembolism.We randomly assigned 822 patients who had completed initial anticoagulant therapy after a first episode of unprovoked venous thromboembolism to receive aspirin, at a dose of 100 mg daily, or placebo for up to 4 (...) years. The primary outcome was a recurrence of venous thromboembolism.During a median follow-up period of 37.2 months, venous thromboembolism recurred in 73 of 411 patients assigned to placebo and in 57 of 411 assigned to aspirin (a rate of 6.5% per year vs. 4.8% per year; hazard ratio with aspirin, 0.74; 95% confidence interval [CI], 0.52 to 1.05; P=0.09). Aspirin reduced the rate of the two prespecified secondary composite outcomes: the rate of venous thromboembolism, myocardial infarction, stroke
Bleeding risk in randomized controlled trials comparing warfarin and aspirin: a systematic review and meta-analysis. Warfarin and aspirin (acetylsalicylicacid [ASA]) are the most commonly used anticoagulant and antiplatelet drugs in the treatment of cardiovascular disease.To provide a pooled estimate of the bleeding risk from randomized controlled trials (RCTs) comparing warfarin and ASA at the dose ranges recommended in evidence-based guidelines.Ovid MEDLINE, Embase and the Cochrane Library (...) , up to September 2011, were searched for RCTs comparing bleeding rates in adult patients randomized to warfarin, target International Normalized Ratio (INR) 2.0-3.5, and ASA, 50-650 mg daily, with at least 3 months of follow-up. Pooled odds ratios (ORs) and associated 95% confidence intervals (CIs) were calculated with the inverse variance method and the random effects model.Four thousand four hundred and forty-two abstracts were screened, resulting in eight included studies for final analysis
Effects of regular aspirin on long-term cancer incidence and metastasis: a systematic comparison of evidence from observational studies versus randomised trials. Long-term follow-up of randomised trials of aspirin in prevention of vascular events showed that daily aspirin reduced the incidence of colorectal cancer and several other cancers and reduced metastasis. However, statistical power was inadequate to establish effects on less common cancers and on cancers in women. Observational studies (...) could provide this information if results can be shown to be reliable. We therefore compared effects of aspirin on risk and outcome of cancer in observational studies versus randomised trials.For this systematic review, we searched for case-control and cohort studies published from 1950 to 2011 that reported associations between aspirin use and risk or outcome of cancer. Associations were pooled across studies by meta-analysis and stratified by duration, dose, and frequency of aspirin use
Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. Daily aspirin reduces the long-term risk of death due to cancer. However, the short-term effect is less certain, especially in women, effects on cancer incidence are largely unknown, and the time course of risk and benefit in primary prevention is unclear. We studied cancer deaths in all trials of daily aspirin versus (...) control and the time course of effects of low-dose aspirin on cancer incidence and other outcomes in trials in primary prevention.We studied individual patient data from randomised trials of daily aspirin versus no aspirin in prevention of vascular events. Death due to cancer, all non-vascular death, vascular death, and all deaths were assessed in all eligible trials. In trials of low-dose aspirin in primary prevention, we also established the time course of effects on incident cancer, major vascular
Effect of daily aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trials. Daily aspirin reduces the long-term incidence of some adenocarcinomas, but effects on mortality due to some cancers appear after only a few years, suggesting that it might also reduce growth or metastasis. We established the frequency of distant metastasis in patients who developed cancer during trials of daily aspirin versus control.Our analysis included all five large (...) randomised trials of daily aspirin (≥75 mg daily) versus control for the prevention of vascular events in the UK. Electronic and paper records were reviewed for all patients with incident cancer. The effect of aspirin on risk of metastases at presentation or on subsequent follow-up (including post-trial follow-up of in-trial cancers) was stratified by tumour histology (adenocarcinoma vs other) and clinical characteristics.Of 17,285 trial participants, 987 had a new solid cancer diagnosed during mean
Low-dose aspirin and cancer mortality: a meta-analysis of randomized trials. Low-dose aspirin is a common strategy for preventing cardiovascular disease and associated mortality. A recent individual patient data meta-analysis of 8 trials of low- and high-dose aspirin, with long-term follow-up, found important reductions in cancer mortality. We aimed to determine whether cancer mortality also is reduced by low-dose aspirin in the shorter term.We conducted a comprehensive search of 10 electronic (...) databases up to December 2011. We conducted a meta-analysis using data from all randomized clinical trials evaluating low-dose (75-325 mg) daily aspirin. We extracted data on non-cardiovascular disease mortality and cancer mortality. We pooled studies using a random-effects model and conducted a meta-regression. We supplemented this with a cumulative meta-analysis and trial sequential monitoring analysis.Twenty-three randomized studies reported on nonvascular death. There were 944 nonvascular deaths
Aspirin use and breast cancer risk: a meta-analysis. Animal and in vitro studies suggest that the use of aspirin may be associated with reduced risk for breast cancer, but results from these studies of the association have been inconsistent. The objective of this meta-analysis was to quantitatively summarize the current evidence for such a relationship. We searched MEDLINE for studies of aspirin use and breast cancer risk that were published in any language, from January 1, 1966, to July 1 (...) , 2011. A total of 33 studies (19 cohort studies, 13 case-control studies, and 1 randomized controlled trial [RCT]) that included 1,916,448 subjects were identified. We pooled the relative risks from individual studies using a random-effects model, heterogeneity, and publication bias analyses. In a pooled analysis of all studies, aspirin use was associated with reduced risk for breast cancer (odds ratio [OR] = 0.86, 95% confidence interval [CI] = 0.81, 0.92). In the subgroup analysis by study design