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41. The effect of reducing the incidence of gastrointestinal complications in patients treated with aspirin, referred to Imam Hospital, of Ahvaz, Iran Full Text available with Trip Pro

with Helicobacter pylori infection is associated with a decreasing risk of gastrointestinal bleeding (O'connor et al., 2013) [1]. In this study, 165 patients with positive helicobacter pylori infection test were chosen among those who were referred to Imam H. In this paper, the effects of sex, smoking, renal failer, diabetes, age, blood pressure and aspirin consumption have been studied (Fletcher et al., 2010) [2]. After completion of the observations and records of patient's medical records, the obtained coded (...) The effect of reducing the incidence of gastrointestinal complications in patients treated with aspirin, referred to Imam Hospital, of Ahvaz, Iran This research contains data which were obtained during the analysis of treated patients with aspirin who were referred to Imam Hospital (Imam H) of Ahvaz, Iran; and the effect of this type of treatment (Helicobacter pylori eradicate (HPE)) on reducing the incidence of gastrointestinal complications. Studies have shown that taking aspirin in patients

2017 Data in brief

42. Aspirin

Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention trial demonstrated that in women who were at high risk for preterm preeclampsia with delivery at aspirin administration from 11 2018 3. Systematic review with meta analysis: Aspirin reduces cardiovascular events in primary prevention of cardiovascular disease but at a near equivalent risk of increased bleeding Aspirin reduces cardiovascular events in primary prevention of cardiovascular disease (...) * your user name or password? You are here Aspirin reduces cardiovascular events in primary prevention of cardiovascular disease but at a near equivalent risk of increased bleeding Article Text Therapeutics/Prevention Systematic review 2016 4. Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. Background 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

2018 Trip Latest and Greatest

43. Bleeding Risks With Aspirin Use for Primary Prevention in Adults: A Systematic Review for the U.S. Preventive Services Task Force. Full Text available with Trip Pro

, controlled trials; cohort studies; and meta-analyses comparing aspirin with placebo or no treatment to prevent CVD or cancer in adults.One investigator abstracted data, another checked for accuracy, and 2 assessed study quality.In CVD primary prevention studies, very-low-dose aspirin use (≤100 mg daily or every other day) increased major gastrointestinal (GI) bleeding risk by 58% (odds ratio [OR], 1.58 [95% CI, 1.29 to 1.95]) and hemorrhagic stroke risk by 27% (OR, 1.27 [CI, 0.96 to 1.68]). Projected (...) Bleeding Risks With Aspirin Use for Primary Prevention in Adults: A Systematic Review for the U.S. Preventive Services Task Force. The balance between potential aspirin-related risks and benefits is critical in primary prevention.To evaluate the risk for serious bleeding with regular aspirin use in cardiovascular disease (CVD) primary prevention.PubMed, MEDLINE, Cochrane Central Register of Controlled Trials (2010 through 6 January 2015), and relevant references from other reviews.Randomized

2016 Annals of Internal Medicine

44. Prognostic Significance of Elevated Cardiac Troponin in Acute Gastrointestinal Bleeding Full Text available with Trip Pro

Prognostic Significance of Elevated Cardiac Troponin in Acute Gastrointestinal Bleeding Acute gastrointestinal bleeding (AGIB) is responsible for over 140,000 hospitalizations annually. Cardiovascular-related deaths account for 30% of the patients surviving the initial episode of AGIB. The purpose of this study was to identify the impact of elevated troponin on short-term mortality and length of stay (LOS) of these patients.From July 2013 to July 2016, 290 patients admitted with a diagnosis (...) , 21% died in the same period (6/29, P = 0.001). The LOS was also higher in patients with troponin elevation (6 vs. 5 days, P = 0.02). There was no difference in 30-day readmission among the two groups. Past history of coronary artery disease, congestive heart failure, hypertension, aspirin use and elevated creatinine was more common in patients with troponin elevation. On multivariate analysis, troponin elevation on presentation is associated with increased mortality (odds: 5.50, CI: 1.73 - 17.47

2017 Gastroenterology research

45. Etiology and Long-term Rebleeding of Endoscopic Ulcerative Lesions in the Small Bowel in Patients with Obscure Gastrointestinal Bleeding: A Multicenter Cohort Study. (Abstract)

Etiology and Long-term Rebleeding of Endoscopic Ulcerative Lesions in the Small Bowel in Patients with Obscure Gastrointestinal Bleeding: A Multicenter Cohort Study. Among patients with obscure gastrointestinal bleeding (OGIB), endoscopic ulcerative lesions in the small bowel have diverse etiologies and often cause rebleeding. Certain characteristics of patients or ulcerations may be reasonable indications for diagnostic balloon-assisted endoscopy (BAE) to assess etiology and may be risks (...) , rebleeding occurred in 14 (21%) patients during a mean follow-up period of 17 months. Aspirin use and multiple ulcerations were significant predictors of rebleeding (P < 0.05).When we manage small bowel ulcerative lesions in OGIB patients, a single ulceration is a reasonable indication for the diagnostic BAE. The rebleeding rate was lower for single ulcerations than for multiple ulcerations.© 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

2017 Journal of gastroenterology and hepatology

46. Severity of Gastrointestinal Bleeding in Patients Treated with Direct-Acting Oral Anticoagulants. (Abstract)

selected a control group of 296 patients with gastrointestinal bleeding who were not receiving anticoagulation treatment from the same sample. Outcomes included the need for hospitalization, blood transfusion, endoscopic or surgical intervention, and 30-day mortality.The DOAC and warfarin groups were similar in terms of age and underlying comorbidity (assessed using the Charlson Comorbidity Index), but the DOAC group had greater concomitant aspirin use. Gastrointestinal bleeding was classified as upper (...) with DOACs compared with warfarin, our data suggest that gastrointestinal bleeding in patients taking DOACs may be less severe. These differences occurred despite significantly greater concomitant aspirin use in the DOAC group compared with warfarin users.Copyright © 2018 Elsevier Inc. All rights reserved.

2017 American Journal of Medicine

47. Lower Gastrointestinal Bleeding in Patients with Coronary Artery Disease on Antithrombotics and Subsequent Mortality Risk. (Abstract)

Lower Gastrointestinal Bleeding in Patients with Coronary Artery Disease on Antithrombotics and Subsequent Mortality Risk. Lower gastrointestinal bleeding (LGIB) is a common complication for patients with coronary artery disease (CAD) due to the use of antithrombotic medications. Limited data exist describing which patients are at increased risk for mortality.This study aims to (i) determine whether patients on dual antiplatelet therapy (DAPT) or triple therapy are at higher risk of 90-day (...) and 6-month mortality compared with patients on aspirin alone and (ii) evaluate risk factors for mortality in patients with CAD on antithrombotics hospitalized with LGIB.We conducted a retrospective cohort study of patients hospitalized with LGIB and CAD while on aspirin at a single academic medical center from 2007 to 2015. Patients were identified using a validated, machine-learning algorithm and classified by use of aspirin, DAPT, or triple therapy. Univariate and multivariate Cox proportional

2017 Journal of gastroenterology and hepatology

48. Risk analysis of new oral anticoagulants for gastrointestinal bleeding and intracranial hemorrhage in atrial fibrillation patients: a systematic review and network meta-analysis. Full Text available with Trip Pro

Risk analysis of new oral anticoagulants for gastrointestinal bleeding and intracranial hemorrhage in atrial fibrillation patients: a systematic review and network meta-analysis. Antithrombotic therapy using new oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) has been generally shown to have a favorable risk-benefit profile. Since there has been dispute about the risks of gastrointestinal bleeding (GIB) and intracranial hemorrhage (ICH), we sought to conduct a systematic (...) intervals (CIs) were modeled using Markov chain Monte Carlo methods.Indirect comparisons with the Bayesian model confirmed that aspirin+clopidogrel significantly increased the risk of GIB in AF patients compared to the placebo (OR 0.33, 95% CI 0.01-0.92). Warfarin was identified as greatly increasing the risk of ICH compared to edoxaban 30 mg (OR 3.42, 95% CI 1.22-7.24) and dabigatran 110 mg (OR 3.56, 95% CI 1.10-8.45). We further ranked the NOACs for the lowest risk of GIB (apixaban 5 mg) and ICH

2017 Journal of Zhejiang University. Science. B

49. New clinical paradigms for treating and preventing antiplatelet gastrointestinal bleeding. (Abstract)

New clinical paradigms for treating and preventing antiplatelet gastrointestinal bleeding. To quantify antiplatelet-related gastrointestinal bleeding (GIB), characterize patients at greatest risk and summarize risk-management strategies emphasizing evolving knowledge in acute management of antiplatelet-related bleeding.New paradigms for acute management of antiplatelet-related GIB exist in the domains of resuscitation and the transfusion of blood products, strategic use of proton pump therapy (...) and identification and eradication of Helicobacter pylori. This review will also highlight the importance of prompt resumption of cardiac aspirin and dual antiplatelet therapy following endoscopic hemostasis to minimize the risk of future cardiac events.This review will provide pragmatic strategies for the management of acute antiplatelet-related GIB. Emerging areas of clinical knowledge will be addressed and knowledge gaps requiring further research to inform clinical practice will be highlighted.

2017 Current opinion in gastroenterology

50. Is the Risk of Bleeding Among Older Adults With Atrial Fibrillation Lower With Antiplatelet Compared With Oral Anticoagulants?

Is the Risk of Bleeding Among Older Adults With Atrial Fibrillation Lower With Antiplatelet Compared With Oral Anticoagulants? TAKE-HOME MESSAGE Older adults have a lower risk of any severity of bleeding (includes both major and minor bleeding) when treated with aspirin or clopidogrel compared to warfarin. However, if minor bleeding is excluded, only the subgroup of patients aged 80 years or older demonstrate a lower risk the of major bleeding with antiplatelet agents. Is the Risk of Bleeding (...) Among Older Adults With Atrial Fibrillation Lower With Antiplatelet Compared With Oral Anticoagulants? EBEM Commentators Cameron Gettel, MD Elizabeth M. Goldberg, MD, ScM Department of Emergency Medicine Alpert Medical School of Brown University Providence, RI Results Commentary Several systematic reviews have previously shown that the risk of bleeding with long-term treatment with aspirin was lower than with warfarin. 2,3 It is common clinical practice to use antiplatelet agents as alternatives

2018 Annals of Emergency Medicine Systematic Review Snapshots

51. Low-Dose Aspirin Use During Pregnancy

with an increased risk of major gastrointestinal and cerebral bleeding episodes (15). In one RCT of low-dose aspirin during pregnancy for the prevention of preeclampsia, transfusion risk was slightly greater in treated patients, (4.0% versus 3.2%) (16). VOL. 132, NO. 1, JULY 2018 Committee Opinion Low-Dose Aspirin During Pregnancy e45Fetal Risks Several systematic reviews of trials using low-dose aspirin for prevention of preeclampsia have shown no increased risk of congenital anomalies (12–14). Moreover (...) bronchospasm (27). Relative con- traindications to low-dose aspirin include a history of gastrointestinal bleeding, active peptic ulcer disease, other sources of gastrointestinal or genitourinary bleed- ing, and severe hepatic dysfunction. Reye syndrome has been reported rarely (less than 1%) in children younger than 18 years who are given aspirin while recovering from viral illnesses, particularly influenza and chicken- pox. The decision to continue low-dose aspirin in the presence of obstetric bleeding

2018 American College of Obstetricians and Gynecologists

52. Low-Dose Aspirin Use During Pregnancy

with an increased risk of major gastrointestinal and cerebral bleeding episodes (15). In one RCT of low-dose aspirin during pregnancy for the prevention of preeclampsia, transfusion risk was slightly greater in treated patients, (4.0% versus 3.2%) (16). VOL. 132, NO. 1, JULY 2018 Committee Opinion Low-Dose Aspirin During Pregnancy e45Fetal Risks Several systematic reviews of trials using low-dose aspirin for prevention of preeclampsia have shown no increased risk of congenital anomalies (12–14). Moreover (...) bronchospasm (27). Relative con- traindications to low-dose aspirin include a history of gastrointestinal bleeding, active peptic ulcer disease, other sources of gastrointestinal or genitourinary bleed- ing, and severe hepatic dysfunction. Reye syndrome has been reported rarely (less than 1%) in children younger than 18 years who are given aspirin while recovering from viral illnesses, particularly influenza and chicken- pox. The decision to continue low-dose aspirin in the presence of obstetric bleeding

2018 American College of Obstetricians and Gynecologists

53. Thoughts On Prolonged Bleeding Whilst Taking Baby Aspirin

their ranks. Doctors mostly worry about major bleeding caused by aspirin; things like bleeding from the gastrointestinal (GI) tract, or into the head. A recent found that baby aspirin doubles the risk of bleeding from the upper GI tract, and increases the risk of intracranial hemorrhage by a factor of 1.4. There is relatively little concern about the type of minor bleeding I experienced. However, beginning in 2010, the Bleeding Academic Research Consortium (BARC) i came up with a more precise way (...) one on prolonged bleeding, specifically, the patient,whom I don’t know if you saw in person, and her “little red spots” on her arm. Are petechiae a possibility? says: If they are its because aspirin depletes vitamin C – petechiae are an early sign of vitamin C deficiency. In addition, supplementing with vitamin C can improve the gastrointestinal tolerability of aspirin My previous cardiologist was overjoyed at the sight of all those ‘blood-thinner’ bruises over both forearms, deeming them as Proof

2018 The Skeptical Cardiologist

54. Continued Antiplatelet Therapy and Risk of Bleeding in Gastrointestinal Procedures: A Systematic Review (Abstract)

Continued Antiplatelet Therapy and Risk of Bleeding in Gastrointestinal Procedures: A Systematic Review Management of perioperative antiplatelet medications in gastrointestinal (GI) surgery is challenging. The risk of intraoperative and postoperative bleeding is associated with perioperative use of antiplatelet medication. However, cessation of these drugs may be unsafe for patients who are required to maintain antiplatelet use due to cardiovascular conditions. The objective of this systematic (...) review was to compare the risk of intraoperative or postoperative bleeding among patients who had GI surgery while on continuous antiplatelet therapy (aspirin, clopidogrel, or dual therapy) with the risk among those not taking continuous antiplatelet medication.We reviewed articles published between January 2000 and July 2015 from the Medline Ovid and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Studies involving any GI procedures were included if the articles met our

2016 EvidenceUpdates

55. Aspirin as an adjuvant treatment for cancer: feasibility results from the Add-Aspirin randomised trial. (Abstract)

-in period, with no upper gastrointestinal bleeding (any grade) in the gastro-oesophageal cancer cohort. The most frequent grade 1-2 toxicity overall was dyspepsia (246 [11%] of 2253 participants).Aspirin is well-tolerated after radical cancer therapy. Toxicity has been low and there is no evidence of a difference in adherence, acceptance of randomisation, or toxicity between the different cancer cohorts. Trial recruitment continues to determine whether aspirin could offer a potential low cost and well (...) to address concerns about toxicity, particularly bleeding after radical treatment for gastro-oesophageal cancer.The Add-Aspirin protocol includes four phase 3 randomised controlled trials evaluating the effect of daily aspirin on recurrence and survival after radical cancer therapy in four tumour cohorts: gastro-oesophageal, colorectal, breast, and prostate cancer. An open-label run-in phase (aspirin 100 mg daily for 8 weeks) precedes double-blind randomisation (for participants aged under 75 years

2019 The lancet. Gastroenterology & hepatology Controlled trial quality: predicted high

56. Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part I: Review of Anticoagulation Agents and Clinical Considerations Full Text available with Trip Pro

) . P2Y12 Inhibitors The oral thienopyridine agents (clopidogrel, ticlopidine, and prasugrel) are prodrugs that are metabolized by cytochrome P450 in the liver and whose metabolites irreversibly inhibit the P2Y12 ADP receptor to reduce platelet aggregation. They are more potent antiplatelet agents than aspirin, and often used in combination with aspirin (ie, dual antiplatelet therapy [DAPT]) to reduce thrombotic events after cardiac interventions. Bleeding risks from medications in this group (...) Hemost . 2012 ; 38 : 845–853 ) (35) . Clopidogrel is commonly used, and less perioperative bleeding was noted when clopidogrel was stopped 5 days before surgery in the Clopidogrel in Unstable angina to prevent Recurrent ischemic Events trial ( x 34 Fox, K.A., Mehta, S.R., Peters, R. et al. Clopidogrel in Unstable angina to prevent Recurrent ischemic Events Trial. Benefits and risks of the combination of clopidogrel and aspirin in patients undergoing surgical revascularization for non-ST-elevation

2019 Society of Interventional Radiology

57. Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part II: Recommendations. Full Text available with Trip Pro

: 261–267 ) (31) , 2,182 patients who required interruption of anticoagulation were followed for 3 months. Bleeding was associated with “bridging,” active cancer, previous bleeding, and reinitiation of heparin within 24 hours of a procedure. The most common surgical procedures were gastrointestinal and orthopedic; interventional radiologic procedures as a general category represented 3% of the procedures studied and were uniformly categorized as low-risk. Multivariate analysis of the results (...) Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part II: Recommendations. Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part II: Recommendations - Journal of Vascular and Interventional Radiology Email/Username: Password

2019 Society of Interventional Radiology

58. Primary non-variceal upper gastrointestinal bleeding in NSAID and low-dose aspirin users: development and validation of risk scores for either medication in two large Dutch cohorts. (Abstract)

Primary non-variceal upper gastrointestinal bleeding in NSAID and low-dose aspirin users: development and validation of risk scores for either medication in two large Dutch cohorts. Non-steroidal anti-inflammatory drugs (NSAIDs) and low-dose acetylsalicylic acid (ASA) have several adverse gastrointestinal (GI) effects, including upper GI bleeding. We aimed to develop a simple risk score to identify high risk NSAID and ASA users for primary upper GI bleeding.Using data from two large anonymized (...) health insurance databases, we defined a development and validation cohort with NSAID and ASA users which were followed-up for the occurrence of a primary upper GI bleeding. Cox regression analyses identified risk factors which were combined into simple risk scores. C-statistics were used to evaluate the discriminative ability of these scores in a validation cohort.In total, 421 cases of upper GI bleeding were identified in the initial cohort of 784,263 NSAID users (incidence rate 54.2 per 10,000

2014 Journal of gastroenterology

59. Low-dose aspirin and upper gastrointestinal bleeding in primary versus secondary cardiovascular prevention: a population-based, nested case-control study. Full Text available with Trip Pro

Low-dose aspirin and upper gastrointestinal bleeding in primary versus secondary cardiovascular prevention: a population-based, nested case-control study. The benefit-risk profile of low-dose aspirin in primary prevention of cardiovascular disease is unclear. We sought to quantify upper gastrointestinal bleeding (UGIB) risk associated with low-dose aspirin in secondary versus primary prevention patients.We performed a population-based nested case-control study using The Health Improvement (...) Network (THIN) Database between 2000 and 2007. We identified 2049 cases of UGIB and 20,000 controls, frequency-matched to the cases on age, sex, and calendar year, who were subdivided into primary (without previous cardiovascular disease) and secondary (with previous cardiovascular disease) prevention populations. We estimated the relative risk of UGIB associated with the use of low-dose aspirin by multivariate logistic regression. The UGIB risk in patients taking low-dose aspirin relative to nonusers

2014 Circulation. Cardiovascular quality and outcomes

60. The benefits and harms of aspirin for people with type 2 diabetes are finely balanced

event during follow-up: 8.5% compared with 9.6% taking placebo (rate ratio [RR] 0.88, 95% confidence interval [CI] 0.79 to 0.97). There was no difference in the number of deaths from vascular causes. However, aspirin similarly increased the number of people who experienced a major bleed: 4.1% compared with 3.2% taking placebo (RR 1.29, 95% CI 1.09 to 1.52), of which 41% were gastrointestinal bleeds. The rate of fatal bleeds was equivalent in both groups (0.2%), as was the rate of haemorrhagic stroke (...) [CI] 0.79 to 0.97). There was no difference in the number of deaths from vascular causes. However, aspirin similarly increased the number of people who experienced a major bleed: 4.1% compared with 3.2% taking placebo (RR 1.29, 95% CI 1.09 to 1.52), of which 41% were gastrointestinal bleeds. The rate of fatal bleeds was equivalent in both groups (0.2%), as was the rate of haemorrhagic stroke (0.3%). This gave a close risk-benefit balance: about 91 people with diabetes would need to take aspirin

2019 NIHR Dissemination Centre

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