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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-sulfinpyrazone in prophylaxis of deep venous thrombosis in total hip replacement. In postoperative hip arthroplasty patients, treatment with aspirin and sulfinpyrazone resulted in a statistically significant reduction of venographically diagnosed thrombi in the proximal veins of the leg. This reduction was most apparent in thrombi that involved the iliac vein. When compared with their placebo-treated counterparts, female patients who received the active treatment experienced
Protective effects of aspirin against acute myocardial infarction and death in men with unstable angina. Results of a Veterans Administration Cooperative Study. We conducted a multicenter, double-blind, placebo-controlled randomized trial of aspirin treatment (324 mg in buffered solution daily) for 12 weeks in 1266 men with unstable angina (625 taking aspirin and 641 placebo). The principal end points were death and acute myocardial infarction diagnosed by the presence of creatine kinase MB (...) or pathologic Q-wave changes on electrocardiograms. The incidence of death or acute myocardial infarction was 51 per cent lower in the aspirin group than in the placebo group: 31 patients (5.0 per cent) as compared with 65 (10.1 per cent); P = 0.0005. Nonfatal acute myocardial infarction was 51 per cent lower in the aspirin group: 21 patients (3.4 per cent) as compared with 44 (6.9 per cent); P = 0.005. The reduction in mortality in the aspirin group was also 51 per cent--10 patients (1.6 per cent
A controlled comparison of aspirin and oral anticoagulants in prevention of death after myocardial infarction. Although neither aspirin nor oral anticoagulants have been conclusively shown to reduce mortality in patients surviving myocardial infarction, both have been widely used for that purpose. In the present clinical trial we compared the effects of aspirin (0.5 g given three times a day) and oral-anticoagulant therapy. Of 6908 patients considered for entry, 1303 were randomized (...) to anticoagulant (652) or aspirin (651) an average of 11.4 days after the onset of myocardial infarction and were followed for 6 to 59 months (mean, 29 months). There were 65 deaths in the anticoagulant group and 72 in the aspirin group. The number of patients with reinfarctions was higher in the aspirin group (33 vs. 20). None of these differences were statistically significant. Almost twice as many patients were withdrawn from therapy in the aspirin group. There were 54 per cent more patients
A platelet-inhibitor-drug trial in coronary-artery bypass operations: benefit of perioperative dipyridamole and aspirin therapy on early postoperative vein-graft patency. To prevent occlusion of aortocoronary-artery-bypass grafts, we conducted a prospective, randomized-double-blind trial comparing dipyridamole (instituted two days before operation) plus aspirin (added seven hours after operation) with placebo in 407 patients. Vein-graft angiography was performed in 360 patients (88 per cent (...) was similar in the two groups. In this trial dipyridamole and aspirin were effective in preventing graft occlusion early after operation.
Trolamine salicylate cream in osteoarthritis of the knee. Twenty-five patients with symptomatic osteoarthritis (OA) of the knee were treated topically for one week with either 10% trolamine salicylate cream or placebo cream in a randomized double-blind crossover study. No significant difference was found in subjective or objective measures of pain relief between the treatment and control groups. Eight patients preferred "active" test cream, six preferred placebo, and 11 had no preference (...) . No side effects were reported. Topically applied 10% trolamine salicylate cream did not relieve the pain of OA of the knee any more than did placebo.
Trial of dipyridamole-aspirin in recurring venous thrombosis. 38 patients (26 men) with recurring venous thromboembolism (RVTE) were enrolled in a prospective double-blind, placebo-controlled trial of dipyridamole (DPY), 100 mg a day, and aspirin (ASA), 1200 mg a day. Platelet survival (51Cr labelling of autologous platelets) was measured every 6 months for 18 months. 19 patients were randomised to treatment with DPY and ASA, and 1 had new venous thrombosis (after 15 months of treatment); 19 (...) received placebo and 7 had new venous thrombosis (4--16 months later (chi 2 = 5.70; p< 0.05). DPY-ASA increased platelet survival whereas placebo treatment did not. The results suggest that in patients with RVTE and abnormal platelet survival time DPY in combination with ASA decreases the frequency of new venous thrombosis. Peptic ulcers developed in 2 patients treated with DPY-ASA.
Randomised trial of pentoxifylline versus acetylsalicylicacid plus dipyridamole in preventing transient ischaemic attacks. In a multicentre trial to compare the ability of a combination of acetylsalicylicacid and dipyridamole (1050 mg + 150 mg/day, group A) to prevent recurrence of transient ischaemic attacks (TIA) with that of pentoxifylline (1200 mg/day, group B), 36 patients received the combination and 30 pentoxifylline. There was no statistically significant difference between the groups
Aspirin and secondary mortality after myocardial infarction. A randomised controlled double-blind trial of aspirin in the prevention of death was conducted in 1682 patients (including 248 women) who had had a confirmed myocardial infarct (MI). 25% of the patients were admitted to the trial within 3 days of the infarction and 50% within 7 days. Aspirin, 300 mg three times daily, was given for 1 yr. Total mortality was 12.3% in patients given aspirin and 14.8% in those given placebo, a reduction (...) by aspirin of 17%, which was not statistically significant at p less than 0.05. The reduction in specific ischaemic-heart-disease (IHD) mortality was 22% and in total mortality plus IHD morbidity (readmission to hospital for MI in survivors) was 28%.
Clinical trials of intra-articular aspirin in rheumatoid arthritis. The effect of the intra-articular injection of acetylsalicylicacid in patients with rheumatoid arthritis was compared with that of hydrocortisone acetate and with that of saline in blind, controlled, clinical trials. All three preparations were effective in relieving pain and improving the range of motion, and no significant differences were demonstrated. The results suggest a need for the re-appraisal of the value of intra
taking enteric-coated aspirin. 5 subjects developed duodenal erosions while taking regular aspirin, whereas none developed an erosion while taking enteric-coated aspirin. Mean fasting salicylate levels were similar in the two groups. It is concluded that regular aspirin causes a greater amount of gastroduodenal mucosal damage than does enteric-coated aspirin despite similar serum-salicylate levels. This suggests that the topical effects of aspirin are of greater importance than the systemic effects (...) Comparison of the effects of regular and enteric-coated aspirin on gastroduodenal mucosa of man. To determine whether the topical or systemic effects of aspirin are of greater importance in the production of gastroduodenal mucosal damage, the effects of regular and enteric-coated aspirin were compared in 9 healthy volunteers in a 2-week crossover endoscopic study. All subjects developed multiple gastric erosions while taking regular aspirin; 2 subjects developed one gastric erosion each while
Reduction by aspirin of intestinal fluid-loss in acute childhood gastroenteritis. Soluble aspirin was given by mouth in therapeutic doses in a double-blind trial to malnourished infants and young children with gastroenteritis and dehydration. Faecal fluid-losses were reduced and weight-grain was enhanced in the group given aspirin. These effects were statistically significant when compared with those obtained with a placebo preparation and in a group of patients given supportive therapy (...) but no specific drug treatment. The results suggest that aspirin may be useful in reducing intestinal fluid-loss in childhood gastroenteritis. Before the widespread use of aspirin can be recommended, its effects in patients not under hospital supervision must be determined.
Blockade of chlorpropamide alcohol flush by aspirin. The blocking effects of aspirin, chlorpheniramine, and cimetidine were tested against the flush provoked by alcohol in twenty-four chlorpropamide-treated patients with non-insulin-dependent diabetes mellitus. Active preparations were compared in a double-blind manner with an indistinguishable placebo. Aspirin significantly decreased the number of patients who flushed. Five patients studied in detail all showed suppression of chlorpropamide (...) /alcohol flush by aspirin, with a mean facial temperature increase during the flush of 2.4 degrees C after pretreatment with placebo and an increase of 0.4 degrees C after pretreatment with aspirin.
A randomized, controlled trial of aspirin in persons recovered from myocardial infarction. The Aspirin Myocardial Infarction Study (AMIS) was a National Heart, Lung and Blood Institute-sponsored, multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of aspirin to men and women who had experienced at least one documented myocardial infarction (MI) would result in a significant reduction in total mortality over a three-year period (...) . Cause-specific mortality, nonfatal events, and side effects were also evaluated. Over a 13-month period, 4,524 persons between the ages of 30 and 69 years were randomized to either 1 g of aspirin per day (2,267 persons) or placebo (2,257 persons). High levels of patient compliance to study protocol were indicated by various measures. Total mortality during the entire follow-up period was 10.8% in the aspirin group and 9.7% in the placebo group. Three-year total mortality was 9.6% in the aspirin
Prevention of thrombosis in patients on hemodialysis by low-dose aspirin. Since platelet cyclo-oxygenase is much more sensitive to inactivation by aspirin than is the enzyme in the arterial wall and low doses of aspirin may prevent thrombosis by blocking thromboxane synthesis, we conducted a randomized, double-blind trial of aspirin (160 mg per day) vs. placebo in 44 patients on chronic hemodialysis. The study was continued until there were 24 patients with thrombi and both groups had been (...) under observation for a mean of nearly five months. Thrombi occurred in 18 of 25 (72 per cent) of patients given placebo and 16 of 19 (32 per cent) of those given aspirin (P less than 0.01). The incidence of thrombosis was reduced from 0.46 thrombi per patient month in the placebo group to 0.16 thrombi per patient month in the aspirin group (p less than 0.005). A dose of 160 mg of aspirin per day is an effective, nontoxic antithrombotic regimen in patients on hemodialysis.
A randomized trial of aspirin and sulfinpyrazone in threatened stroke. The Canadian Cooperative Study Group. Five hundred and eighty-five patients with threatened stroke were followed in a randomized clinical trial for an average of 26 months to determine whether aspirin or sulfinpyrazone, singly or in combination, influence the subsequent occurrence of continuing transient ischemic attacks, stroke or death. Eighty-five subjects went on to stroke, and 42 died. Aspirin reduced the risk (...) was not statistically significant. No overall synergism or antagonism was observed between the two drugs. We conclude that aspirin is an efficacious drug for men with threatened stroke.
Gastrointestinal blood loss. Effect of aspirin, fenoprofen, and acetaminophen in rheumatoid arthritis as determined by sequential gastroscopy and radioactive fecal markers. The feasibility of determining the exact site and amount of drug-induced gastric bleeding was tested. Fourteen patients with rheumatoid arthritis received equivalent therapeutic doses of the antinflammatory drugs aspirin, 4 gm/day, and fenoprofen calcium, 2.4 gm/day, in randomized order for seven days. Acetaminophen (...) was given for 14 days just prior to each of these periods. By fiberoptic gastroscopy, antral ulceration and acute mucosal lesions were found in seven patients following aspirin ingestion, in one taking fenoprofen, and in none taking acetaminophen. Fecal blood loss in four-day stool collections, quantitated by autologous chromium 51-labeled erythrocytes shed into the stool averaged 5.0 ml/day while taking aspirin, 2.2 ml/day while taking fenoprofen calcium, and 0.8 ml/day while taking acetaminophen
Ibuprofen or aspirin in rheumatoid arthritis therapy. Ibuprofen is a nonsteroidal drug with analgesic, antipyretic, and anti-inflammatory properties that was recently introduced for use in antiarthritis therapy in the United States. In a year-long double-blind multiclinic trial in 885 patients with rheumatoid arthritis, ibuprofen was at least as satisfactory as aspirin, considering both efficacy and tolerance. In the majority of patients, daily doses ranged from 800 to 1,600 mg of ibuprofen (...) and 3 to 6 gm of aspirin. The drugs did not differ greatly in providing relief from arthritis symptoms, but ibuprofen was definitely better tolerated, especially in regard to gastrointestinal complaints. Seven percent of the ibuprofen group dropped out of the study because of adverse reactions, as compared with 16% of the aspirin group; 17% of the ibuprofen group and 31% of the aspirin group had gastrointestinal symptoms.