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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
The evidence strength of a meta-analysis of aspirin for primary prevention of cancer. Dr. Tarek Haykal et al. (145:1795-1809, 2019) reported a meta-analysis of aspirin for the primary prevention of cancer in individuals without known cancer. The authors found that aspirin use was not associated with significant reduction in cancer mortality or incidence, but with higher rates of bleeding. The findings of this study added some evidence to the clinical practice. However, several issues might have
Clinical Outcomes of Aspirin Interaction with Other Non-Steroidal Anti-Inflammatory Drugs: A Systematic Review. Concomitant use of some non-Aspirin nonsteroidal anti-inflammatory drugs (NANSAIDs) reduces the extent of platelet aggregation of Aspirin (acetylsalicylicacid). This is while many observational studies and clinical trials suggest that Aspirin reduces cardiovascular (CV) risk attributed to the use of NANSAIDs. Thus, the therapeutic outcome of the interaction needs to be assessed.We (...) ., no need for near complete aggregation. In addition, cardioprotective effect of Aspirin, despite reduced platelet aggregation caused by NANSAIDs, may be through its involvement in other mechanisms such as the renin-angiotensin system and/or metabolism of arachidonic acid to biologically active compounds mediated by cytochrome P450. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.
The Efficacy And Safety Of Aspirin As The Primary Prevention Of Cardiovascular Disease: An Updated Meta-Analysis. Information regarding the use of aspirin for patients with no known cardiovascular disease remains conflicting. We performed an updated meta-analysis to evaluate the efficacy and safety of aspirin for primary prevention of cardiovascular disease.PubMed, MEDLINE, and Cochrane library databases were searched for randomized controlled trials comparing aspirin with placebos (...) or no treatment published up until November 1, 2018. The primary efficacy endpoint was all-cause death. The secondary endpoints included cardiovascular death, myocardial infarction, and stroke. The safety endpoints included major bleeding, gastrointestinal bleeding, and hemorrhagic stroke.Fourteen studies were included. Aspirin use was associated with a lower risk of myocardial infarction than placebo use or no treatment (risk ratio [RR], 0.83, 95% confidence interval [CI]: 0.73-0.95, P = 0.005). Additionally
AcetylsalicylicAcid for Primary Prevention of Cardiovascular Events: Clinical Effectiveness and Guidelines AcetylsalicylicAcid for Primary Prevention of Cardiovascular Events: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need AcetylsalicylicAcid for Primary Prevention of Cardiovascular Events: Clinical Effectiveness and Guidelines AcetylsalicylicAcid for Primary Prevention of Cardiovascular Events: Clinical Effectiveness and Guidelines Last updated: August 19 (...) , 2019 Project Number: RB1368-000 Product Line: Research Type: Drug Report Type: Summary of Abstracts Result type: Report Question What is the clinical effectiveness for the use of acetylsalicylicacid in primary prevention of cardiovascular disease? What are the evidence-based guidelines for the use of acetylsalicylicacid in primary prevention of cardiovascular disease? Key Message Twenty-two systematic reviews and meta-analyses, eight randomized controlled trials, and eleven non-randomized studies
Estimating individual lifetime benefit and bleeding risk of adding rivaroxaban to aspirin for patients with stable cardiovascular disease: results from the COMPASS trial Adding rivaroxaban to aspirin in patients with stable atherosclerotic disease reduces the recurrence of cardiovascular disease (CVD) but increases the risk of major bleeding. The aim of this study was to estimate the individual lifetime treatment benefit and harm of adding low-dose rivaroxaban to aspirin in patients with stable (...) cardiovascular disease.Patients with established CVD from the COMPASS trial (n = 27 390) and SMART prospective cohort study (n = 8139) were used. Using the pre-existing lifetime SMART-REACH model for recurrent CVD, and a newly developed Fine and Gray competing risk-adjusted lifetime model for major bleeding, individual treatment effects from adding low-dose rivaroxaban to aspirin in patients with stable CVD were estimated, expressed in terms of (i) life-years free of stroke or myocardial infarction (MI
Safety of Proton Pump Inhibitors Based on a Large, Multi-Year, Randomized Trial of Patients Receiving Rivaroxaban or Aspirin Proton pump inhibitors (PPIs) are effective at treating acid-related disorders. These drugs are well tolerated in the short term, but long-term treatment was associated with adverse events in observational studies. We aimed to confirm these findings in an adequately powered randomized trial.We performed a 3 × 2 partial factorial double-blind trial of 17,598 participants (...) with stable cardiovascular disease and peripheral artery disease randomly assigned to groups given pantoprazole (40 mg daily, n = 8791) or placebo (n = 8807). Participants were also randomly assigned to groups that received rivaroxaban (2.5 mg twice daily) with aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg) alone. We collected data on development of pneumonia, Clostridium difficile infection, other enteric infections, fractures, gastric atrophy, chronic kidney disease
Topical Cantharidin/ SalicylicAcid/ Podophyllin for the Treatment of Warts: Clinical Effectiveness and Guidelines Topical Cantharidin/ SalicylicAcid/ Podophyllin for the Treatment of Warts: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Topical Cantharidin/ SalicylicAcid/ Podophyllin for the Treatment of Warts: Clinical Effectiveness and Guidelines Topical Cantharidin/ SalicylicAcid/ Podophyllin for the Treatment of Warts: Clinical Effectiveness (...) and Guidelines Last updated: January 21, 2019 Project Number: RA1006-000 Product Line: Research Type: Drug Report Type: Reference List Result type: Report Question What is the comparative clinical effectiveness of topical cantharidin/salicylicacid/podophyllin versus other topical treatments for warts? What are the evidence-based guidelines for the topical treatment of warts? Key Message One non-randomized study and two evidence-based guidelines were identified regarding topical cantharidin/ salicylicacid
Aspirin and Primary Prevention in Patients with Diabetes-A Critical Evaluation of Available Randomized Trials and Meta-Analyses. Primary prevention of cardiovascular events with aspirin in patients with elevated cardiovascular risk, including diabetics, is currently under intense discussion. Data from meta-analyses suggests that the efficacy of aspirin in these patients is low, whereas there is a significantly increased bleeding tendency. However, meta-analyses are based on trials that differ (...) in many important aspects, including study selection. Fresh insights were expected from the ASCEND trial, by far the largest primary, randomized, placebo-controlled prevention trial in diabetics without known cardiovascular disease. There was a small but significant reduction in serious cardiovascular events by aspirin (8.6% vs. 9.6%) but also a significant increase in major bleeding: 4.1% versus 3.2%. Unfortunately, this trial did not meet the desired annual rate of elevated vascular risk of ≥ 2
Ticagrelor with or without Aspirin in High-Risk Patients after PCI. Monotherapy with a P2Y12 inhibitor after a minimum period of dual antiplatelet therapy is an emerging approach to reduce the risk of bleeding after percutaneous coronary intervention (PCI).In a double-blind trial, we examined the effect of ticagrelor alone as compared with ticagrelor plus aspirin with regard to clinically relevant bleeding among patients who were at high risk for bleeding or an ischemic event and had undergone (...) PCI. After 3 months of treatment with ticagrelor plus aspirin, patients who had not had a major bleeding event or ischemic event continued to take ticagrelor and were randomly assigned to receive aspirin or placebo for 1 year. The primary end point was Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding. We also evaluated the composite end point of death from any cause, nonfatal myocardial infarction, or nonfatal stroke, using a noninferiority hypothesis with an absolute margin
Response by de Veer et al to Letter Regarding Article, "Efficacy and Safety of the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation and Concomitant Aspirin Therapy: A Meta-Analysis of Randomized Trials". 30354436 2019 09 24 2019 09 25 1524-4539 138 12 2018 09 18 Circulation Circulation Response by de Veer et al to Letter Regarding Article, "Efficacy and Safety of the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients (...) With Nonvalvular Atrial Fibrillation and Concomitant Aspirin Therapy: A Meta-Analysis of Randomized Trials". 1279 10.1161/CIRCULATIONAHA.118.035885 de Veer Anne J W M AJWM Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. Bennaghmouch Naoual N Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. Mahmoodi Bakhtawar K BK Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. Ten Berg Jurriën M JM Department of Cardiology, St. Antonius
Letter by Tong et al Regarding Article, "Efficacy and Safety of the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation and Concomitant Aspirin Therapy: A Meta-Analysis of Randomized Trials". 30354435 2019 09 24 2019 09 25 1524-4539 138 12 2018 09 18 Circulation Circulation Letter by Tong et al Regarding Article, "Efficacy and Safety of the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation (...) and Concomitant Aspirin Therapy: A Meta-Analysis of Randomized Trials". 1277-1278 10.1161/CIRCULATIONAHA.118.035321 Tong Suiyang S Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Zhang Liangliang L Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Joseph Jacob J Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital
Response to Commentary for 'Efficacy and safety of aspirin for primary prevention of cardiovascular events: a meta-analysis and trial sequential analysis of randomized controlled trials'. 31005974 2019 09 20 1522-9645 40 34 2019 Sep 07 European heart journal Eur. Heart J. Response to Commentary for 'Efficacy and safety of aspirin for primary prevention of cardiovascular events: a meta-analysis and trial sequential analysis of randomized controlled trials'. 2924-2925 10.1093/eurheartj/ehz224
: An updated meta-analysis on aspirin use in primary prevention of cardiovascular disease in patients with diabetes. 30744399 2019 09 18 2047-4881 26 15 2019 Oct European journal of preventive cardiology Eur J Prev Cardiol Primum non nocere : An updated meta-analysis on aspirin use in primary prevention of cardiovascular disease in patients with diabetes. 1677-1679 10.1177/2047487319826439 Fortuni Federico F Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione
Personalized Prediction of Cardiovascular Benefits and Bleeding Harms From Aspirin for Primary Prevention: A Benefit-Harm Analysis. Whether the benefits of aspirin for the primary prevention of cardiovascular disease (CVD) outweigh its bleeding harms in some patients is unclear.To identify persons without CVD for whom aspirin would probably result in a net benefit.Individualized benefit-harm analysis based on sex-specific risk scores and estimates of the proportional effect of aspirin on CVD (...) and major bleeding from a 2019 meta-analysis.New Zealand primary care.245 028 persons (43.6% women) aged 30 to 79 years without established CVD who had their CVD risk assessed between 2012 and 2016.The net effect of aspirin was calculated for each participant by subtracting the number of CVD events likely to be prevented (CVD risk score × proportional effect of aspirin on CVD risk) from the number of major bleeds likely to be caused (major bleed risk score × proportional effect of aspirin on major
Benefits and harms of aspirin desensitization for aspirin-exacerbated respiratory disease: a systematic review and meta-analysis. Aspirin desensitization is increasingly recommended for the treatment of aspirin-exacerbated respiratory disease (AERD). The objective of this study is to systematically review the efficacy and safety of aspirin desensitization in patients with AERD.We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and World Health Organization (WHO (...) ) International Clinical Trials Registry Platform from inception to January 5, 2019. We included randomized trials and comparative observational studies in any language. Data extraction and risk of bias assessment were performed in duplicate independently.Five randomized controlled trials (RCTs) enrolled 233 patients with AERD. Compared to placebo, aspirin desensitization (mean daily dose 800 mg) improved quality of life (risk ratio [RR] 2.00; 95% confidence interval [CI], 1.31 to 3.06; heterogeneity measure
Does low-dose aspirin initiated before 11 weeks' gestation reduce the rate of preeclampsia? Preconception or early administration of low-dose aspirin might improve endometrial growth, placental vascularization, and organogenesis. Most studies have evaluated the potential benefit of preconception or early administration of low-dose aspirin in women with a history of recurrent pregnancy loss, women who have undergone in vitro fertilization, or women with thrombophilia or antiphospholipid syndrome (...) . These women are at an increased risk of placenta-associated complications of pregnancy, including preeclampsia, preterm delivery, and fetal growth restriction.We performed a systematic review and meta-analysis to evaluate the effect of low-dose aspirin initiated at <11 weeks' gestation on the risk of preeclampsia, gestational hypertension, or any hypertensive disorder of pregnancy. Secondary outcomes included preterm delivery at <37 weeks' gestation and fetal growth restriction.We searched in MEDLINE via
The impact of low-dose aspirin on adverse perinatal outcomes: a meta-analysis and meta-regression. To perform a meta-analysis and meta-regression of randomized controlled trials (RCTs) to evaluate the impact of low-dose aspirin (LDA) on perinatal outcome, independent of its effect on pre-eclampsia (PE), preterm birth and low birth weight.An electronic search of EMBASE, PubMed, CENTRAL, PROSPERO and Google Scholar databases was performed to identify RCTs assessing the impact of LDA in pregnancy (...) , published in English prior to May 2019, which reported perinatal outcomes of interest (placental abruption, delivery mode, low 5-min Apgar score, neonatal acidosis, neonatal intensive care unit admission, periventricular hemorrhage and perinatal death). Risk ratios (RR) and 95% CI were calculated and pooled for analysis. Analysis was stratified according to gestational age at commencement of treatment (≤ 16 weeks vs > 16 weeks) and subgroup analysis was performed to assess the impact of aspirin dose
Rivaroxaban With or Without Aspirin in Patients With Heart Failure and Chronic Coronary or Peripheral Artery Disease Patients with chronic coronary artery disease or peripheral artery disease and history of heart failure (HF) are at high risk for major adverse cardiovascular events. We explored the effects of rivaroxaban with or without aspirin in these patients.The COMPASS trial (Cardiovascular Outcomes for People Using Anticoagulation Strategies) randomized 27 395 participants with chronic (...) coronary artery disease or peripheral artery disease to rivaroxaban 2.5 mg twice daily plus aspirin 100 mg daily, rivaroxaban 5 mg twice daily alone, or aspirin 100 mg alone. Patients with New York Heart Association functional class III or IV HF or left ventricular ejection fraction (EF) <30% were excluded. The primary major adverse cardiovascular events outcome comprised cardiovascular death, stroke, or myocardial infarction, and the primary safety outcome was major bleeding using modified
Long-term aspirin use for cancer primary prevention: A protocol for updated systematic review and subgroup meta-analysis of randomized clinical trials. Long-term use of aspirin for primary prevention of cancer remains inconclusive, and variation in the effects of aspirin use on cancer outcomes by cancer site, aspirin dose, follow-up duration, or different populations has never been systematically evaluated.Seven electronic databases (PubMed, EMBASE, ClinicalTrials.gov, etc) will be searched (...) from inception to September 30, 2019. Randomized clinical trials (RCTs) comparing aspirin versus no aspirin in participants without pre-existing cancer and reporting cancer incidence, and/or cancer mortality outcomes will be selected and assessed for inclusion. The Cochrane's Risk of Bias Tool and the Jadad scale will be used to evaluate the risk of bias and the methodologic quality of the RCTs. Data will be screened and extracted by independent investigators. Total cancer incidence will be defined
Rivaroxaban versus Aspirin in Prevention of Venous Thromboembolism: A Meta-Analysis of 9 Randomized Controlled Trials comprising 7,656 Patients This article evaluates the preventive effects of rivaroxaban versus aspirin on venous thromboembolism (VTE) through meta-analysis of recent randomized controlled trials (RCTs). RCTs were retrieved from medical literature databases. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to compare the primary and safety endpoints. In total (...) , 9 trials (11 trial comparisons) were retrieved which contained 7,656 patients. Among these patients, 4,383 patients (57.2%) received rivaroxaban, whereas 3,273 patients (42.8%) received aspirin. Compared with aspirin, rivaroxaban significantly reduced VTE (1.3% vs. 3.5%) (RR: 0.36, 95% CI, 0.26-0.48, I2 = 27.9%), but significantly increased nonmajor bleeding (11.5% vs. 7.5%) (RR: 1.28, 95% CI, 1.13-1.44, I2 = 38.6%). There were no significant differences in the all-cause mortality (0.3% vs. 0.3