Latest & greatest articles for aspirin

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Aspirin

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

The Trip Database has an extensive collection of articles on aspirin ranging from clinical trials, systematic reviews, clinical guidelines and case reports. These can be found via searching the site.

Top results for aspirin

41. Low-dose aspirin is associated with reduced spontaneous preterm birth in nulliparous women (Abstract)

Low-dose aspirin is associated with reduced spontaneous preterm birth in nulliparous women Preterm birth is one of the leading causes of perinatal morbidity and mortality. Clinical data suggest that low-dose aspirin may decrease the rate of overall preterm birth, but investigators have speculated that this is likely due to a decrease in medically indicated preterm birth through its effect on the incidence of preeclampsia and other placental disease. We hypothesized that low-dose aspirin may (...) also have an impact on the mechanism of spontaneous preterm labor.Our objective was to determine whether low-dose aspirin reduces the rate of spontaneous preterm birth in nulliparous women without medical comorbidities.This is a secondary analysis of a randomized, placebo-controlled trial of low-dose aspirin for the prevention of preeclampsia in healthy, low-risk, nulliparous women. Low-risk women were defined by the absence of hypertension, renal disease, diabetes, other endocrine disorders

2018 EvidenceUpdates

42. Effect of Aspirin on All-Cause Mortality in the Healthy Elderly. Full Text available with Trip Pro

Effect of Aspirin on All-Cause Mortality in the Healthy Elderly. In the primary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial, now published in the Journal, we report that the daily use of aspirin did not provide a benefit with regard to the primary end point of disability-free survival among older adults. A numerically higher rate of the secondary end point of death from any cause was observed with aspirin than with placebo.From 2010 through 2014, we enrolled (...) community-dwelling persons in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or disability. Participants were randomly assigned to receive 100 mg of enteric-coated aspirin or placebo. Deaths were classified according to the underlying cause by adjudicators who were unaware of trial-group assignments. Hazard ratios were calculated to compare mortality between

2018 NEJM Controlled trial quality: predicted high

43. Effect of Aspirin on Disability-free Survival in the Healthy Elderly. Full Text available with Trip Pro

Effect of Aspirin on Disability-free Survival in the Healthy Elderly. Information on the use of aspirin to increase healthy independent life span in older persons is limited. Whether 5 years of daily low-dose aspirin therapy would extend disability-free life in healthy seniors is unclear.From 2010 through 2014, we enrolled community-dwelling persons in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did (...) not have cardiovascular disease, dementia, or physical disability. Participants were randomly assigned to receive 100 mg per day of enteric-coated aspirin or placebo orally. The primary end point was a composite of death, dementia, or persistent physical disability. Secondary end points reported in this article included the individual components of the primary end point and major hemorrhage.A total of 19,114 persons with a median age of 74 years were enrolled, of whom 9525 were randomly assigned

2018 NEJM Controlled trial quality: predicted high

44. Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. Full Text available with Trip Pro

Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. Aspirin is a well-established therapy for the secondary prevention of cardiovascular events. However, its role in the primary prevention of cardiovascular disease is unclear, especially in older persons, who have an increased risk.From 2010 through 2014, we enrolled community-dwelling men and women in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics (...) in the United States) and did not have cardiovascular disease, dementia, or disability. Participants were randomly assigned to receive 100 mg of enteric-coated aspirin or placebo. The primary end point was a composite of death, dementia, or persistent physical disability; results for this end point are reported in another article in the Journal. Secondary end points included major hemorrhage and cardiovascular disease (defined as fatal coronary heart disease, nonfatal myocardial infarction, fatal

2018 NEJM Controlled trial quality: predicted high

45. Effect of aspirin in vascular surgery in patients from a randomized clinical trial (POISE-2) (Abstract)

Effect of aspirin in vascular surgery in patients from a randomized clinical trial (POISE-2) In the POISE-2 (PeriOperative ISchemic Evaluation 2) trial, perioperative aspirin did not reduce cardiovascular events, but increased major bleeding. There remains uncertainty regarding the effect of perioperative aspirin in patients undergoing vascular surgery. The aim of this substudy was to determine whether there is a subgroup effect of initiating or continuing aspirin in patients undergoing (...) vascular surgery.POISE-2 was a blinded, randomized trial of patients having non-cardiac surgery. Patients were assigned to perioperative aspirin or placebo. The primary outcome was a composite of death or myocardial infarction at 30 days. Secondary outcomes included: vascular occlusive complications (a composite of amputation and peripheral arterial thrombosis) and major or life-threatening bleeding.Of 10 010 patients in POISE-2, 603 underwent vascular surgery, 319 in the continuation and 284

2018 EvidenceUpdates

46. Efficacy and Safety of Ticagrelor in Relation to Aspirin Use Within the Week Before Randomization in the SOCRATES Trial Full Text available with Trip Pro

Efficacy and Safety of Ticagrelor in Relation to Aspirin Use Within the Week Before Randomization in the SOCRATES Trial SOCRATES (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes), comparing ticagrelor with aspirin in patients with acute cerebral ischemia, found a nonsignificant 11% relative risk reduction for stroke, myocardial infarction, or death (P=0.07). Aspirin intake before randomization could enhance the effect of ticagrelor by conferring (...) dual antiplatelet effect during a high-risk period for subsequent stroke. Therefore, we explored the efficacy and safety of ticagrelor versus aspirin in the patients who received any aspirin the week before randomization.A prespecified subgroup analysis in SOCRATES (n=13 199), randomizing patients with acute ischemic stroke (National Institutes of Health Stroke Scale score of ≤5) or transient ischemic attack (ABCD2 score of ≥4) to 90-day treatment with ticagrelor or aspirin. Patients in the prior

2018 EvidenceUpdates

47. Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. Full Text available with Trip Pro

Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. Diabetes mellitus is associated with an increased risk of cardiovascular events. Aspirin use reduces the risk of occlusive vascular events but increases the risk of bleeding; the balance of benefits and hazards for the prevention of first cardiovascular events in patients with diabetes is unclear.We randomly assigned adults who had diabetes but no evident cardiovascular disease to receive aspirin at a dose of 100 mg (...) of 15,480 participants underwent randomization. During a mean follow-up of 7.4 years, serious vascular events occurred in a significantly lower percentage of participants in the aspirin group than in the placebo group (658 participants [8.5%] vs. 743 [9.6%]; rate ratio, 0.88; 95% confidence interval [CI], 0.79 to 0.97; P=0.01). In contrast, major bleeding events occurred in 314 participants (4.1%) in the aspirin group, as compared with 245 (3.2%) in the placebo group (rate ratio, 1.29; 95% CI, 1.09

2018 NEJM Controlled trial quality: predicted high

48. Ticagrelor plus aspirin for 1 month, followed by ticagrelor monotherapy for 23 months vs aspirin plus clopidogrel or ticagrelor for 12 months, followed by aspirin monotherapy for 12 months after implantation of a drug-eluting stent: a multicentre, open-la Full Text available with Trip Pro

Ticagrelor plus aspirin for 1 month, followed by ticagrelor monotherapy for 23 months vs aspirin plus clopidogrel or ticagrelor for 12 months, followed by aspirin monotherapy for 12 months after implantation of a drug-eluting stent: a multicentre, open-la We hypothesised that ticagrelor, in combination with aspirin for 1 month, followed by ticagrelor alone, improves outcomes after percutaneous coronary intervention compared with standard antiplatelet regimens.GLOBAL LEADERS was a randomised (...) , open-label superiority trial at 130 sites in 18 countries. Patients undergoing percutaneous coronary intervention with a biolimus A9-eluting stent for stable coronary artery disease or acute coronary syndromes were randomly assigned (1:1) to 75-100 mg aspirin daily plus 90 mg ticagrelor twice daily for 1 month, followed by 23 months of ticagrelor monotherapy, or standard dual antiplatelet therapy with 75-100 mg aspirin daily plus either 75 mg clopidogrel daily (for patients with stable coronary

2018 Lancet Controlled trial quality: predicted high

49. Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial. (Abstract)

Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial. The use of aspirin in the primary prevention of cardiovascular events remains controversial. We aimed to assess the efficacy and safety of aspirin versus placebo in patients with a moderate estimated risk of a first cardiovascular event.ARRIVE is a randomised, double-blind, placebo-controlled, multicentre study done (...) in seven countries. Eligible patients were aged 55 years (men) or 60 years (women) and older and had an average cardiovascular risk, deemed to be moderate on the basis of the number of specific risk factors. We excluded patients at high risk of gastrointestinal bleeding or other bleeding, or diabetes. Patients were randomly assigned (1:1) with a computer-generated randomisation code to receive enteric-coated aspirin tablets (100 mg) or placebo tablets, once daily. Patients, investigators, and others

2018 Lancet Controlled trial quality: predicted high

50. Aspirin

still have questions please contact us via jon.brassey@tripdatabase.com Aspirin 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 (...) that the authors' cautious conclusion is warranted. Authors' objectives To investigate the effect of aspirin dose on primary and secondary prevention of cardiovascular events in people with diabetes. Searching MEDLINE, EMBASE, The Cochrane Library (Issue 2, 2010), Web of Science, Science Citation Index, IPA 2011 13. Dietary Omega-3 Fatty Acids and Aspirin are Effective as Adjunctive Therapy During Non-Surgical Treatment of Chronic Periodontitis UTCAT2871, Found CAT view, CRITICALLY APPRAISED TOPICs University

2018 Trip Latest and Greatest

51. Low-Dose Aspirin Use During Pregnancy

). Pathophysiology Aspirin (acetylsalicylic acid) is a nonsteroidal antiin- flammatory drug (NSAID) that works primarily through its inhibition of two cyclooxygenase isoen- zymes (COX-1 and COX-2), which are necessary for prostaglandin biosynthesis. The COX-1 isoform is present in the vascular endothelium and regulates the production of prostacyclin and thromboxane A 2 , pros- taglandins with opposing regulatory effects on vascular homeostasis and platelet function. Prostacyclin is a potent vasodilator (...) ) or hypersensitivity to other salicylates are at risk of anaphylaxis and should not receive low-dose aspirin. Because of significant cross-sensitivity between aspirin and other nonsteroidal drugs, low-dose aspirin is also contraindicated in patients with known hypersensi- tivity to NSAIDs. Exposure to low-dose aspirin in pa- tients with nasal polyps may result in life-threatening bronchoconstriction and should be avoided. The same is true in patients with asthma who have a history of aspirin-induced acute

2018 American College of Obstetricians and Gynecologists

52. A systematic review of the efficacy of aspirin monotherapy versus other antiplatelet therapy regimens in peripheral arterial disease (Abstract)

A systematic review of the efficacy of aspirin monotherapy versus other antiplatelet therapy regimens in peripheral arterial disease Dual antiplatelet therapy (DAPT) usually refers to the administration of aspirin plus a platelet P2Y12 receptor blocker. This combination is commonly prescribed after revascularization procedures in patients with peripheral arterial disease (PAD) to prevent failure of the intervention. However, there is not a consensus among peripheral vascular specialists

2018 EvidenceUpdates

53. A trial of P2Y12 receptor inhibition with prasugrel identifies a potentially distinct endotype of patients with aspirin-exacerbated respiratory disease Full Text available with Trip Pro

A trial of P2Y12 receptor inhibition with prasugrel identifies a potentially distinct endotype of patients with aspirin-exacerbated respiratory disease Aspirin-exacerbated respiratory disease (AERD) is characterized by asthma, recurrent nasal polyposis, and respiratory reactions on ingestion of COX-1 inhibitors. Increased numbers of platelet-leukocyte aggregates are present in the sinus tissue and blood of patients with AERD compared with that of aspirin-tolerant patients, and platelet (...) activation can contribute to aspirin-induced reactions.We sought to determine whether treatment with prasugrel, which inhibits platelet activation by blocking the type 12 purinergic (P2Y12) receptor, would attenuate the severity of sinonasal and respiratory symptoms induced during aspirin challenge in patients with AERD.Forty patients with AERD completed a 10-week, double-blind, placebo-controlled crossover trial of prasugrel. All patients underwent oral aspirin challenges after 4 weeks of prasugrel

2018 EvidenceUpdates

54. Esomeprazole and aspirin in Barrett's oesophagus (AspECT): a randomised factorial trial. Full Text available with Trip Pro

Esomeprazole and aspirin in Barrett's oesophagus (AspECT): a randomised factorial trial. Oesophageal adenocarcinoma is the sixth most common cause of cancer death worldwide and Barrett's oesophagus is the biggest risk factor. We aimed to evaluate the efficacy of high-dose esomeprazole proton-pump inhibitor (PPI) and aspirin for improving outcomes in patients with Barrett's oesophagus.The Aspirin and Esomeprazole Chemoprevention in Barrett's metaplasia Trial had a 2 × 2 factorial design (...) and was done at 84 centres in the UK and one in Canada. Patients with Barrett's oesophagus of 1 cm or more were randomised 1:1:1:1 using a computer-generated schedule held in a central trials unit to receive high-dose (40 mg twice-daily) or low-dose (20 mg once-daily) PPI, with or without aspirin (300 mg per day in the UK, 325 mg per day in Canada) for at least 8 years, in an unblinded manner. Reporting pathologists were masked to treatment allocation. The primary composite endpoint was time to all-cause

2018 Lancet Controlled trial quality: predicted high

55. Aspirin Plus Clopidogrel vs Aspirin Alone for Preventing Cardiovascular Events Among Patients at High Risk for Cardiovascular Events. (Abstract)

Aspirin Plus Clopidogrel vs Aspirin Alone for Preventing Cardiovascular Events Among Patients at High Risk for Cardiovascular Events. Among patients at high risk for or with established cardiovascular disease (ie, history of peripheral artery disease, stroke, or coronary artery disease without a coronary stent), is the addition of clopidogrel to aspirin associated with lower risk of mortality and cardiovascular events compared with aspirin alone?Clopidogrel plus aspirin is associated (...) with a reduced risk for myocardial infarction and ischemic stroke and an increased risk for major bleeding compared with aspirin alone among patients at high risk for or with an established cardiovascular disease but without a coronary stent. However, combined therapy is not associated with lower mortality.

2018 JAMA

56. Effects of aspirin on risks of vascular events and cancer according to bodyweight and dose: analysis of individual patient data from randomised trials. Full Text available with Trip Pro

Effects of aspirin on risks of vascular events and cancer according to bodyweight and dose: analysis of individual patient data from randomised trials. A one-dose-fits-all approach to use of aspirin has yielded only modest benefits in long-term prevention of cardiovascular events, possibly due to underdosing in patients of large body size and excess dosing in patients of small body size, which might also affect other outcomes.Using individual patient data, we analysed the modifying effects (...) of bodyweight (10 kg bands) and height (10 cm bands) on the effects of low doses (≤100 mg) and higher doses (300-325 mg or ≥500 mg) of aspirin in randomised trials of aspirin in primary prevention of cardiovascular events. We stratified the findings by age, sex, and vascular risk factors, and validated them in trials of aspirin in secondary prevention of stroke. Additionally, we assessed whether any weight or height dependence was evident for the effect of aspirin on 20-year risk of colorectal cancer or any

2018 Lancet

57. Effect of Alteplase vs Aspirin on Functional Outcome for Patients With Acute Ischemic Stroke and Minor Nondisabling Neurologic Deficits: The PRISMS Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Alteplase vs Aspirin on Functional Outcome for Patients With Acute Ischemic Stroke and Minor Nondisabling Neurologic Deficits: The PRISMS Randomized Clinical Trial. More than half of patients with acute ischemic stroke have minor neurologic deficits (National Institutes of Health Stroke Scale [NIHSS] score of 0-5) at presentation. Although prior major trials of alteplase included patients with low NIHSS scores, few without clearly disabling deficits were enrolled.To evaluate (...) the efficacy and safety of alteplase in patients with NIHSS scores of 0 to 5 whose deficits are not clearly disabling.The PRISMS trial was designed as a 948-patient, phase 3b, double-blind, double-placebo, multicenter randomized clinical trial of alteplase compared with aspirin for emergent stroke at 75 stroke hospital networks in the United States. Patients with acute ischemic stroke whose deficits were scored as 0 to 5 on the NIHSS and judged not clearly disabling and in whom study treatment could

2018 JAMA Controlled trial quality: predicted high

58. [EINSTEIN CHOICE: Comparison of rivaroxaban treatment and prophylactic doses with aspirin in the extended treatment of patients with venous thromboembolism]. Full Text available with Trip Pro

[EINSTEIN CHOICE: Comparison of rivaroxaban treatment and prophylactic doses with aspirin in the extended treatment of patients with venous thromboembolism]. Although many patients with venous thromboembolism (VTE) may need extended treatment, efficacy and safety issues of full- or lower-intensity anticoagulation over acetyl salicylic acid (ASA) treatment have remained to be determined. EINSTEIN CHOICE is a randomized, double-blind and phase 3 study, and compared either once-daily rivaroxaban (...) of rivaroxaban and in 1.2% of patients receiving 10 mg of rivaroxaban, in comparison to 4.4% of those receiving aspirin (hazard ratio for 20 mg of rivaroxaban vs. ASA, 0.34; 95% confidence interval [CI] 0.20 to 0.59; hazard ratio for 10 mg of rivaroxaban vs. ASA, 0.26; 95% CI 0.14 to 0.47; P<0.001 for both comparisons). Rates of major bleeding and adverse events were comparable among three treatment groups. In conclusion, in patients with VTE in equipoise for extended anticoagulation, either a treatment dose

2018 Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir Controlled trial quality: predicted high

59. Low-Dose Aspirin Use During Pregnancy

). Pathophysiology Aspirin (acetylsalicylic acid) is a nonsteroidal antiin- flammatory drug (NSAID) that works primarily through its inhibition of two cyclooxygenase isoen- zymes (COX-1 and COX-2), which are necessary for prostaglandin biosynthesis. The COX-1 isoform is present in the vascular endothelium and regulates the production of prostacyclin and thromboxane A 2 , pros- taglandins with opposing regulatory effects on vascular homeostasis and platelet function. Prostacyclin is a potent vasodilator (...) ) or hypersensitivity to other salicylates are at risk of anaphylaxis and should not receive low-dose aspirin. Because of significant cross-sensitivity between aspirin and other nonsteroidal drugs, low-dose aspirin is also contraindicated in patients with known hypersensi- tivity to NSAIDs. Exposure to low-dose aspirin in pa- tients with nasal polyps may result in life-threatening bronchoconstriction and should be avoided. The same is true in patients with asthma who have a history of aspirin-induced acute

2018 American College of Obstetricians and Gynecologists

60. Aspirin for Evidence-Based Preeclampsia Prevention trial: effect of aspirin on length of stay in the neonatal intensive care unit Full Text available with Trip Pro

Aspirin for Evidence-Based Preeclampsia Prevention trial: effect of aspirin on length of stay in the neonatal intensive care unit Preeclampsia is a major pregnancy complication with adverse short- and long-term implications for both the mother and baby. Screening for preeclampsia at 11-13 weeks' gestation by a combination of maternal demographic characteristics and medical history with measurements of biomarkers can identify about 75% of women who develop preterm preeclampsia with delivery (...) at <37 weeks' gestation and 90% of those with early preeclampsia at <32 weeks, at a screen-positive rate of 10%. A recent trial (Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention) has reported that in women identified by first-trimester screening as being at high risk for preeclampsia, use of aspirin (150 mg/d from the first to the third trimester), compared to placebo, reduced the incidence of preterm preeclampsia, which

2018 EvidenceUpdates