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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
Randomised controlled trial of streptokinase, aspirin, and combination of both in treatment of acute ischaemic stroke. Multicentre Acute Stroke Trial--Italy (MAST-I) Group. In ischaemic stroke, thrombolytic drugs speed the recanalisation of intracerebral arteries. The effects of aspirin are not known. A trial was conducted to determine whether, separately or together, streptokinase and aspirin have clinical benefits in acute ischaemic stroke similar to those in acute myocardial infarction. 622 (...) patients with acute ischaemic stroke within 6 hours of symptom onset were randomised with a 2 x 2 factorial design to (i) a 1-hour intravenous infusion of 1.5 MU streptokinase, (ii) 300 mg/day buffered aspirin for 10 days, (iii) both active treatments, or (iv) neither. Early results raised a question whether the trial should be continued. Streptokinase (alone or with aspirin) was associated with an excess of 10-day case fatality (odds ratio 2.7; 95% confidence interval 1.7-4.3; 2p < 0.00001
1995LancetControlled trial quality: predicted high
Aspirin and myocardial infarction Aspirin and myocardial infarction Aspirin and myocardial infarction NHS Centre for Reviews and Dissemination 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 NHS Centre for Reviews and Dissemination. Aspirin and myocardial infarction. York: Centre for Reviews and Dissemination (CRD) 1995: 4 Authors (...) ' objectives To summarise the evidence relating to the use of aspirin following myocardial infarction. Authors' conclusions Aspirin as emergency therapy: Aspirin is an effective therapy in patients with acute myocardial infarction. Patients with suspected acute myocardial infarction should receive 150mg aspirin daily. There are very few contraindications for the immediate use of aspirin. Intravenous thrombolytic therapy: Intravenous thrombolytic therapy is also effective in suitable patients. The benefit
Low-dose aspirin: lack of association with an increase in abruptio placentae or perinatal mortality Low-dose aspirin: lack of association with an increase in abruptio placentae or perinatal mortality Low-dose aspirin: lack of association with an increase in abruptio placentae or perinatal mortality Hauth J C, Goldenberg R L, Parker C R, Cutter G R, Cliver S P Authors' objectives To determine the association between low-dose aspirin treatment and subsequent abruptio placentae or perinatal (...) mortality. Searching MEDLINE was searched from January 1985 to April 1994, using the headings: 'human pregnancy', 'pregnancy-induced hypertension'. 'preeclampsia', 'aspirin', 'hypertension', 'clinical trials' and 'abruptio placentae'. Reference lists from all retrieved reports, review articles and chapters from textbooks were examined to locate further trials. Only published, English language literature was considered for inclusion. Study selection Study designs of evaluations included in the review
the efficacy of aspirin (ASA) and/or intravenous immunoglobulin (IVIG) in the prevention of coronary artery aneurysm (CAA) in children with Kawasaki disease. Searching MEDLINE and EMBASE were searched from 1967 to 1993 with the subject heading 'mucocutaneous lymph node syndrome' and subheadings 'coronary aneurysm' and 'coronary artery aneurysm'. Additional articles were identified from bibliographies of retrieved articles. Study selection Study designs of evaluations included in the review Prospective (...) of ASA and IVIG in preventing CAA in children with Kawasaki disease are required. Bibliographic details Durongpisitkul K, Gururaj V J, Park J M, Martin C F. The prevention of coronary artery aneurysm in Kawasaki disease: a meta-analysis on the efficacy of aspirin and immunoglobulin treatment. Pediatrics 1995; 96(6): 1057-1061 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Aspirin /therapeutic use; Child; Coronary Aneurysm /etiology /prevention & Humans; Immunoglobulins, Intravenous
Cost-effectiveness of warfarin and aspirin for prophylaxis of stroke in patients with nonvalvular atrial fibrillation Cost-effectiveness of warfarin and aspirin for prophylaxis of stroke in patients with nonvalvular atrial fibrillation Cost-effectiveness of warfarin and aspirin for prophylaxis of stroke in patients with nonvalvular atrial fibrillation Gage B, Cardinalli A, Albers G, Owens D Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion (...) In the base case analysis, patients were 65 years old, had NVAF and were 'good candidates for warfarin and aspirin therapy'. Setting The economic study was carried out in California, USA. Dates to which data relate Effectiveness and resource use data were taken from a range of studies published between 1989 and 1995. Costs were given in 1994 prices. Source of effectiveness data Estimates of effectiveness were obtained from a review of the previously published studies. Modelling A Markov model was used
Randomised trial of oral aspirin for chronic venous leg ulcers. The effect of oral aspirin on the healing rate of chronic venous leg ulcers was compared with that of placebo in a double-blind randomised trial. 20 subjects with chronic venous leg ulcers were randomised to daily enteric-coated aspirin 300 mg or placebo, and standardised compression bandaging. 4 months of treatment achieved ulcer healing in 38% of the patients receiving aspirin compared with 0% of those receiving placebo (p (...) < 0.007). 52% of the aspirin-treated group showed significant reduction in ulcer size compared with 26% of placebo recipients (p < 0.007). Reduction in ulcer surface area was significantly better in the aspirin-treated group at 2 (p < 0.01) and 4 months (p < 0.002) compared with that in the placebo group.
CLASP: a randomised trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women. CLASP (Collaborative Low-dose Aspirin Study in Pregnancy) Collaborative Group. Pre-eclampsia is a common and serious complication of pregnancy that affects both mother and child. Review of previous small trials of antiplatelet therapy, particularly low-dose aspirin, suggested reductions of about three-quarters in the incidence of pre-eclampsia and some avoidance (...) of intrauterine growth retardation (IUGR), but larger trials have not confirmed these results. In our multicentre study 9364 women were randomly assigned 60 mg aspirin daily or matching placebo. 74% were entered for prophylaxis of pre-eclampsia, 12% for prophylaxis of IUGR, 12% for treatment of pre-eclampsia, and 3% for treatment of IUGR. Overall, the use of aspirin was associated with a reduction of only 12% in the incidence of proteinuric pre-eclampsia, which was not significant. Nor was there any
Warfarin versus aspirin for prevention of thromboembolism in atrial fibrillation: Stroke Prevention in Atrial Fibrillation II Study. Warfarin is an established treatment for prevention of ischaemic stroke in patients with atrial fibrillation, but the value of this agent relative to aspirin in unclear. In the first Stroke Prevention in Atrial Fibrillation (SPAF-I) study, direct comparison of warfarin with aspirin was limited by the small number of thromboembolic events. SPAF-II aims to address (...) this issue and also to assess the differential effects of the two treatments according to age. We compared warfarin (prothrombin time ratio 1.3-1.8, international normalised ratio 2.0-4.5) with aspirin 325 mg daily for prevention of ischaemic stroke and systemic embolism (primary events) in two parallel randomised trials involving 715 patients aged 75 years or less and 385 patients older than 75; we sought reductions in the absolute rate of primary events by warfarin compared with aspirin of 2% per year
Low-molecular weight heparin versus aspirin and dipyridamole after femoropopliteal bypass grafting. Low-molecular weight heparin has theoretical advantages over aspirin and dipyridamole in maintaining vascular-graft patency by virtue of its better antithrombotic effect and antiproliferative activity on vascular, smooth-muscle cells. We tested the hypothesis that low-molecular weight heparin would be more effective than aspirin and dipyridamole in maintaining graft patency in patients undergoing (...) femoropopliteal bypass grafting. Patients were randomised to receive either a daily injection of 2500 IU low-molecular weight heparin, or 300 mg aspirin with 100 mg dipyridamole 8 hourly for 3 months. 94 patients were randomised to low-molecular weight heparin and 106 to aspirin and dipyridamole. Patients were stratified according to indication for surgery and were followed up for 1 year. Kaplan-Meier estimate of graft patency showed 87% graft survival on low-molecular-weight heparin and 72% on aspirin
Effect of aspirin on risk of stroke or death in women who have suffered cerebral ischemia Effect of aspirin on risk of stroke or death in women who have suffered cerebral ischemia Effect of aspirin on risk of stroke or death in women who have suffered cerebral ischemia Jonas S Authors' objectives To investigate the effect of aspirin on occurrence of stroke or death in women who have previously suffered cerebral ischaemia. Searching Studies were identified by searching MEDLINE, and English (...) -language medical, neurological and stroke journals; by examining previous meta-analyses; and by discussion with colleagues at international and national stroke meetings. Study selection Study designs of evaluations included in the review Randomised double-blind trials were included. Specific interventions included in the review Aspirin; placebo. Participants included in the review Patients who had suffered transient ischaemia or stroke in the carotid or vertebrobasilar artery territories, were included
Prevention of one-year vein-graft occlusion after aortocoronary-bypass surgery: a comparison of low-dose aspirin, low-dose aspirin plus dipyridamole, and oral anticoagulants. The CABADAS Research Group of the Interuniversity Cardiology Institute of The Ne Aspirin, alone or in combination with dipyridamole, is known to prevent occlusion of aortocoronary vein grafts. The benefit of dipyridamole in addition to aspirin remains controversial, and the efficacy and safety of oral anticoagulants (...) for prevention of vein-graft occlusion have not been established. We assessed one-year angiographic vein-graft patency after aortocoronary-bypass surgery in 948 patients assigned to receive aspirin, aspirin plus dipyridamole, or oral anticoagulants in a prospective, randomised trial. The design was double-blind and placebo-controlled for the aspirin groups, but open for oral anticoagulant treatment. Dipyridamole (5 mg/kg per 24 h intravenously for 28 h, followed by 200 mg twice daily) and oral anticoagulants
1993LancetControlled trial quality: predicted high
Effect of aspirin and non-steroidal anti-inflammatory drugs on colorectal adenomas: case-control study of subjects participating in the Nottingham faecal occult blood screening programme. To examine the relation between the use of aspirin and non-steroidal anti-inflammatory drugs and the presence of asymptomatic colorectal adenomas.Case-control study of subjects participating in a randomised controlled trial of faecal occult blood screening for colorectal cancer. Data on analgesics and other (...) colorectal adenomas according to frequency and duration of use of analgesics.Cases reported taking less aspirin and non-steroidal anti-inflammatory drugs than the negative controls, with the estimated relative risk for any use being 0.49 (95% confidence interval 0.3 to 0.8). The inverse association was less strong when cases were compared with the positive controls (0.66 (0.4 to 1.1)). The association was specific for aspirin and non-steroidal anti-inflammatory drugs there being no association
Prevention of preeclampsia with low-dose aspirin in healthy, nulliparous pregnant women. The National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Although low-dose aspirin has been reported to reduce the incidence of preeclampsia among women at high risk for this complication, its efficacy and safety in healthy, nulliparous pregnant women are not known.We studied 3135 normotensive nulliparous women who were 13 to 26 weeks pregnant to determine (...) whether treatment with aspirin reduced the incidence of preeclampsia. Of this group, 1570 women received 60 mg of aspirin per day and 1565 received placebo for the remainder of their pregnancies. We also evaluated the effect of aspirin on maternal and neonatal morbidity.Of the original group of 3135 women, 2985 (95 percent) were followed throughout pregnancy and the immediate puerperium. The incidence of preeclampsia was lower in the aspirin group (69 of 1485 women [4.6 percent]) than in the placebo
Low-dose aspirin in prevention and treatment of intrauterine growth retardation and pregnancy-induced hypertension. Italian study of aspirin in pregnancy. Meta-analysis of data from several controlled trials has shown that low-dose aspirin reduces the risk of pregnancy-induced hypertension (PIH) and intrauterine growth retardation (IUGR) in women at high risk of these disorders. We have assessed the efficacy of low-dose aspirin in women judged to be at moderate risk. Women were included (...) on prophylactic criteria--age under 18 or over 40 years, mild or moderate chronic hypertension (diastolic pressure between 90 and 110 mm Hg), nephropathy with normal renal function and blood pressure, history of PIH or IUGR, and twin pregnancy--or therapeutic criteria--PIH or early signs of IUGR in current pregnancy. Eligible women were randomly assigned treatment with 50 mg aspirin daily until delivery (583) or no treatment (523); 18 and 46 women, respectively, were lost to follow-up. The groups were well
A comparison of aspirin with placebo in patients treated with warfarin after heart-valve replacement. Despite the use of warfarin, major systemic embolism remains an important complication in patients with heart-valve replacement. Although the addition of antiplatelet agents has the potential to reduce this complication, their efficacy and safety when given in combination with warfarin are uncertain.In a randomized, double-blind, placebo-controlled trial, we assessed the efficacy and safety (...) of adding aspirin (100 mg per day) to warfarin treatment (target international normalized ratio, 3.0 to 4.5) in 370 patients with mechanical heart valves or with tissue valves plus atrial fibrillation or a history of thromboembolism.A total of 186 patients were randomly assigned to aspirin and 184 to placebo, and they were followed for up to 4 years (average, 2.5). Major systemic embolism or death from vascular causes occurred in 6 aspirin-treated patients (1.9 percent per year) and 24 placebo-treated
[Prevention of intrauterine growth retardation and pre-eclampsia by small doses of aspirin. Results of the french multicenter trial EPREDA and comparison with data in the literature; value of uterine Doppler]. 1351078 1992 07 16 2018 11 30 0368-2315 21 3 1992 Journal de gynecologie, obstetrique et biologie de la reproduction J Gynecol Obstet Biol Reprod (Paris) [Prevention of intrauterine growth retardation and pre-eclampsia by small doses of aspirin. Results of the french multicenter trial (...) Biol Reprod (Paris) 0322206 0150-9918 64ALC7F90C Dipyridamole R16CO5Y76E Aspirin IM Aspirin administration & dosage therapeutic use Dipyridamole administration & dosage therapeutic use Double-Blind Method Drug Therapy, Combination Female Fetal Growth Retardation diagnostic imaging drug therapy prevention & control Humans Pre-Eclampsia diagnostic imaging drug therapy prevention & control Pregnancy Prospective Studies Ultrasonography, Prenatal standards 1992 1 1 1992 1 1 0 1 1992 1 1 0 0 ppublish
ISIS-3: a randomised comparison of streptokinase vs tissue plasminogen activator vs anistreplase and of aspirin plus heparin vs aspirin alone among 41,299 cases of suspected acute myocardial infarction. ISIS-3 (Third International Study of Infarct Surviva 41,299 patients entering 914 hospitals up to 24 h (median 4 h) after the onset of suspected acute myocardial infarction were randomised between streptokinase (SK: 1.5 MU infused over about 1 h), tissue plasminogen activator (tPA, duteplase (...) : 0.60 MU/kg infused over about 4 h), or anisoylated plasminogen-streptokinase activator complex (APSAC), anistreplase: 30 U over about 3 min). All patients were to receive aspirin (162 mg/day enteric-coated), with the first tablet chewed for rapid and full antiplatelet effect. Half of all patients were randomly allocated subcutaneous calcium heparin (12,500 IU starting at 4 h and given twice daily for 7 days or until prior discharge) in addition to aspirin, and the other half were to receive aspirin
Aspirin effects on mortality and morbidity in patients with diabetes mellitus. Early Treatment Diabetic Retinopathy Study report 14. ETDRS Investigators. This report presents information on the effects of aspirin on mortality, the occurrence of cardiovascular events, and the incidence of kidney disease in the patients enrolled in the Early Treatment Diabetic Retinopathy Study (ETDRS).This multicenter, randomized clinical trial of aspirin vs placebo was sponsored by the National Eye (...) Institute.Patients (N = 3711) were enrolled in 22 clinical centers between April 1980 and July 1985. Men and women between the ages of 18 and 70 years with a clinical diagnosis of diabetes mellitus were eligible. Approximately 30% of all patients were considered to have type I diabetes mellitus, 31% type II, and in 39% type I or II could not be determined definitely.Patients were randomly assigned to aspirin or placebo (two 325-mg tablets once per day).Mortality from all causes was specified as the primary
Prevention of serious cardiac events by low-dose aspirin in patients with silent myocardial ischaemia. The Research Group on Instability in Coronary Artery Disease in Southeast Sweden. On exercise testing after an episode of unstable coronary artery disease (CAD; unstable angina or non-Q-wave myocardial infarction), a proportion of patients show ST-segment depression, indicating myocardial ischaemia, but do not report concomitant symptoms of angina. Treatment of such "silent" ischaemia aims (...) mainly to reduce the risk of subsequent cardiac events. We have studied the effect of low-dose aspirin in patients with myocardial ischaemia defined at the predischarge test as silent (though patients might have had symptomatic ischaemia at other times) or symptomatic. 740 men with unstable CAD aged 70 years or less underwent symptom-limited exercise testing before hospital discharge; 144 showed ST depression without pain and 230 ST depression with simultaneous chest pain. Of the silent ischaemia
Low-dose aspirin and subsequent peripheral arterial surgery in the Physicians' Health Study. In the US Physicians' Health Study the early termination of the aspirin arm has provided the opportunity to test the hypothesis that low-dose aspirin (325 mg on alternate days) might affect the subsequent occurrence of peripheral arterial surgery. In the study, a randomised double-blind placebo-controlled trial among 22,071 healthy US male physicians aged 40-84, there were, during an average of 60.2 (...) months of treatment and follow-up, 56 participants who underwent peripheral arterial surgery (20 aspirin, 36 placebo). The relative risk of peripheral artery surgery in the aspirin group was 0.54 (95% confidence intervals 0.30-0.95; p = 0.03). These data indicate that chronic administration of low-dose aspirin to apparently healthy men reduced the need for peripheral arterial surgery.
1992LancetControlled trial quality: predicted high