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aspirin and gastrointestinal bleeding

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7621. Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis

Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis Derry S, Loke Y K Authors' objectives To assess the incidence of gastrointestinal haemorrhage associated with long-term aspirin therapy, and to determine the effect of dose reduction and formulation on the incidence of such haemorrhage. Searching Two (...) authors independently searched MEDLINE and EMBASE from 1990 to 1999 using the free text terms: 'aspirin' or 'acetylsalicylic*', or 'salicylic*'. The authors also selected trials from a list of 200 antiplatelet studies identified in a previous systematic review (see Other Publications of Related Interest), and manually checked the reference lists of retrieved studies. No language restrictions were reported. Study selection Study designs of evaluations included in the review Randomised controlled trials

2000 DARE.

7622. CASPAR : Clopidogrel and Acetyl Salicylic Acid in Bypass Surgery for Peripheral ARterial Disease

months of randomization Previous or current intracranial hemorrhage or hemorrhagic stroke, or any previous stroke for which the diagnosis of hemorrhagic stroke cannot be excluded Any history of severe spontaneous bleeding such as gastrointestinal bleeding, gross hematuria, intraocular bleeding Other medical conditions Previous disabling stroke (severe cerebral deficit such that the patient is bedridden or demented) NYHA Class IV heart failure Uncontrolled hypertension: Systolic Blood Pressure (SBP (...) CASPAR : Clopidogrel and Acetyl Salicylic Acid in Bypass Surgery for Peripheral ARterial Disease CASPAR : Clopidogrel and Acetyl Salicylic Acid in Bypass Surgery for Peripheral ARterial Disease - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one

2005 Clinical Trials

7623. Upper gastrointestinal mucosal abnormalities and blood loss complicating low-dose aspirin and antithrombotic therapy. Full Text available with Trip Pro

Upper gastrointestinal mucosal abnormalities and blood loss complicating low-dose aspirin and antithrombotic therapy. Little is known about the site and nature of bleeding lesions related to low-dose aspirin and other antithrombotic agents.To describe the mucosal abnormalities in patients presenting with upper gastrointestinal bleeding while being treated with these drugs.The endoscopic findings and clinical details were analysed in all patients presenting with haematemesis and/or melaena (...) at a single centre during three calendar years. Associations between endoscopic findings and risk factors, including the intake of non-steroidal anti-inflammatory drugs, low-dose aspirin (75 mg daily) and other antithrombotic drugs including warfarin, clopidogrel, and dipyridamole, were assessed by logistic regression analysis.In 674 upper gastrointestinal bleeders, we found that the odds ratio for the presence of erosive oesophagitis in aspirin users was 2 (95% CI, 1-3; P = 0.03) and 3 (2-5; P = 0.0003

2006 Alimentary Pharmacology & Therapeutics

7624. What is the risk of GI bleeding with selective serotonin reuptake inhibitors (SSRIs)?

the risk of upper GI bleeding, and this effect is potentiated by concurrent use of nonsteroidal anti-inflammatory drugs or low-dose aspirin, whereas an increased risk of upper GI bleeding could not be attributed to other types of antidepressants." An earlier case-control study examining1651 incident cases of upper gastrointestinal bleeding and 248 cases of ulcer perforation among patients of UK general practice aged 40 to 79 years between April 1993 and September 1997, and 10 000 controls matched (...) types including images, videos, patient information leaflets, educational courses and news. For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com What is the risk of GI bleeding with selective serotonin reuptake inhibitors (SSRIs)? We found one cohort study (1) and one case-control study (2) examining the risk of gastrointestinal bleeding with selective serotonin

2003 TRIP Answers

7625. Reduced risk of large-bowel adenomas among aspirin users. The Polyp Prevention Study Group. (Abstract)

on risk of large-bowel neoplasms in a study in which aspirin use would not be expected to affect tumor detection and tumor-related symptoms would not likely influence aspirin use. A less complicated assessment of the relationship between aspirin and large-bowel tumors should thus be possible.We studied 793 patients enrolled in a clinical trial of nutrient supplements to prevent large-bowel adenomas. Unlike invasive cancers, adenomas usually do not cause symptoms or detectable gastrointestinal bleeding (...) Reduced risk of large-bowel adenomas among aspirin users. The Polyp Prevention Study Group. Epidemiological studies have indicated that aspirin consumption can lower the risk of large-bowel cancer. These studies are not entirely consistent, however, and their interpretation has been complicated by the possibility that cancer symptoms may have led patients to avoid aspirin or that aspirin may have influenced cancer diagnosis and treatment.Our purpose was to determine the effect of aspirin

1993 Journal of the National Cancer Institute.

7626. A double-blind, placebo-controlled, 6-day evaluation of two doses of misoprostol in gastroduodenal mucosal protection against damage from aspirin and effect on bowel habits. (Abstract)

against injury due to anti-inflammatory doses of aspirin (3900 mg/day); and 2) to determine whether the reduced dose was associated with a lesser incidence of gastrointestinal (GI) side effects, particularly diarrhea. All subjects received 975 mg of aspirin qid with meals and at bedtime. They were concurrently administered either misoprostol 200 micrograms qid, misoprostol 200 micrograms bid and placebo bid, or placebo qid. All subjects were endoscopically normal at the onset of the study and were re (...) -endoscoped on the morning of the 7th day of therapy, 2 h after the morning dose of medications. Gastric and duodenal mucosa were assessed separately on a 0-7 scale which gave a greater weight to erosions than to hemorrhages. GI symptoms, especially bowel habits, were assessed by means of diary cards. Subjects in both misoprostol groups had significantly less gastric and duodenal mucosal injury than subjects who received placebo (p less than 0.007 for each pairwise comparison). There was no statistically

1991 The American journal of gastroenterology Controlled trial quality: uncertain

7627. Does an 82year old patient with past GI bleed (>20years) need a full dose PPI for gastroprotection whilst taking aspirin 75mg daily or will maintenance dose suffice?

Does an 82year old patient with past GI bleed (>20years) need a full dose PPI for gastroprotection whilst taking aspirin 75mg daily or will maintenance dose suffice? Does an 82year old patient with past GI bleed (>20years) need a full dose PPI for gastroprotection whilst taking aspirin 75mg daily or will maintenance dose suffice? - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere (...) fast’ and this is something we aim to deliver for every single search. As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news. For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com Does an 82year old patient with past GI bleed (>20years) need

2008 TRIP Answers

7628. Please advise regarding the evidence for continuing or stopping aspirin in someone who has had a large GI bleed from severe sigmoid diverticular disease?

Please advise regarding the evidence for continuing or stopping aspirin in someone who has had a large GI bleed from severe sigmoid diverticular disease? Please advise regarding the evidence for continuing or stopping aspirin in someone who has had a large GI bleed from severe sigmoid diverticular disease? - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document (...) has had a large GI bleed from severe sigmoid diverticular disease? Unfortunately, we could find no specific guidance on this topic. We therefore recommend you discuss this with a gastroenterologist, they will be better placed to advise you on the risks/benefits of continuing to use aspirin. Answered 11 December 2007 Follow us: © 2019 Trip Database Ltd. company number 04316414. Trip is proud to be made in the UK.

2007 TRIP Answers

7629. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case-control study Full Text available with Trip Pro

was associated with ulcer perforation. The concurrent use of selective serotonin reuptake inhibitors with non-steroidal anti-inflammatory drugs increased the risk of upper gastrointestinal bleeding beyond the sum of their independent effects (15.6, 6.6 to 36.6). A smaller interaction was also found between selective serotonin reuptake inhibitors and low dose aspirin (7.2, 3.1 to 17.1).Selective serotonin reuptake inhibitors increase the risk of upper gastrointestinal bleeding. The absolute effect is, however (...) , moderate and about equivalent to low dose ibuprofen. The concurrent use of non-steroidal anti-inflammatory drugs or aspirin with selective serotonin reuptake inhibitors greatly increases the risk of upper gastrointestinal bleeding.

1999 BMJ : British Medical Journal

7630. Ranitidine versus ranitidine plus octreotide in the treatment of acute non-variceal upper gastrointestinal bleeding: a prospective randomised study. (Abstract)

Ranitidine versus ranitidine plus octreotide in the treatment of acute non-variceal upper gastrointestinal bleeding: a prospective randomised study. To compare the efficacy of ranitidine with that of ranitidine plus octreotide in the treatment of non-variceal upper gastrointestinal (UGI) bleeding.Prospective, randomised, open study.Upper GI endoscopy was carried out during the first 24 hours in all patients with UGI bleeding who had been admitted within a period of 18 months. Patients (...) , emergency surgical intervention or death. The number of blood units given and the days of hospitalization were also recorded.Aspirin and non-aspirin NSAID use before bleeding was reported by 16/44 (36%) patients in Group A and by 19/40 (47.5%) patients in Group B (p = 0.38, OR = 0.63, 95% CI = 0.26-1.51). The endoscopically detected pathology and bleeding stigmata did not differ between the groups (p = 0.86, p = 0.64, OR = 0.78, 95% CI = 0.3-1.99, respectively). Mean use of blood units (p = 0.16

2000 Current medical research and opinion Controlled trial quality: uncertain

7631. High incidence of clopidogrel-associated gastrointestinal bleeding in patients with previous peptic ulcer disease. (Abstract)

High incidence of clopidogrel-associated gastrointestinal bleeding in patients with previous peptic ulcer disease. In average-risk patients, the new anti-platelet agent, clopidogrel, causes less upper gastrointestinal adverse events than aspirin. However, there are no safety data on the use of clopidogrel in high-risk patients.To evaluate the safety of clopidogrel in patients with peptic ulcer disease in a retrospective cohort longitudinal study.During the period from January 2000 to May 2002 (...) , 70 patients who were prescribed clopidogrel (75 mg/day) for a previous history of non-aspirin-related peptic ulcer disease or a history of aspirin-related gastrointestinal complications (dyspepsia or peptic ulcer) were recruited. The occurrence of ulcer complications (bleeding/perforation/obstruction) was the primary end-point.After a median follow-up of 1 year, nine patients (12%) developed gastrointestinal bleeding and one had a perforated peptic ulcer. Clopidogrel-associated gastrointestinal

2003 Alimentary Pharmacology & Therapeutics

7632. Risk factors for upper gastrointestinal bleeding among end-stage renal disease patients. Full Text available with Trip Pro

Risk factors for upper gastrointestinal bleeding among end-stage renal disease patients. The risk of upper gastrointestinal bleeding (UGIB) is increased among end-stage renal disease (ESRD) patients compared to the general population. However, correlates of UGIB among ESRD patients remain unknown. We conducted a cohort study of dialysis patients to ascertain risk factors for UGIB.Data from the United States Renal Data System Dialysis Morbidity and Mortality Studies, Waves 2-4 were used (...) , diabetes, lower serum albumin, nourishment, treatment modality, aspirin use, nonsteroidal anti-inflammatory drug (NSAID) use, and antiplatelet or anticoagulant medication use were not found to be significantly related to the risk of UGIB after adjustment for potential confounding factors.CVD, current smoking, and risk factors suggesting more disability are associated with a greater risk of UGIB among patients with ESRD.

2003 Kidney International

7633. Validation of a clinical prediction rule for severe acute lower intestinal bleeding. (Abstract)

of consecutive patients admitted to an academic, tertiary care or a community-based teaching hospital for management of acute lower intestinal bleeding. Data were collected on seven previously identified predictors of severe bleeding: heart rate > or = 100/min, systolic blood pressure < or = 115 mmHg, syncope, nontender abdominal exam, rectal bleeding in the first 4 h of evaluation, aspirin use, and >2 comorbid conditions. Severe bleeding was defined as transfusion of > or =2 units of red blood cells (...) , and/or a decrease in hematocrit of > or =20% in the first 24 h, and/or recurrent rectal bleeding after 24 h of stability (accompanied by a further decrease in hematocrit of > or =20%, and/or additional blood transfusions, and/or readmission for acute lower intestinal bleeding within 1 wk of discharge). Patients were stratified into 3 risk groups according to the previously developed prediction rule: low (no risk factors), moderate (1-3 risk factors), and high (>3 risk factors).A total of 275 patients with acute

2005 American Journal of Gastroenterology

7634. Assessment of the Risk Factors for Colonic Diverticular Hemorrhage. (Abstract)

= 0.04), hypertension (odds ratio, 6.6; 95 percent confidence interval, 2.1-20.5; P = 0.0011), and aspirin and/or other anticoagulant (odds ratio, 3; 95 percent confidence interval, 1.04-8.6; P = 0.042) were shown to be significant risk factors by multivariate analysis.Hypertension, nonsteroidal anti-inflammatory drugs, and anticoagulants, including aspirin, are independent risk factors for colonic diverticular hemorrhage. (...) Assessment of the Risk Factors for Colonic Diverticular Hemorrhage. Colonic diverticulosis, although usually asymptomatic, sometimes causes diverticular hemorrhage. Studies about risk factors, other than nonsteroidal anti-inflammatory drugs, for colonic diverticular hemorrhage are limited. We conducted the present study to elucidate their significance as a risk factor.Colonic diverticulosis was found in 1,753 patients and diverticular hemorrhage in 44 patients among 9,499 total colonoscopy

2007 Diseases of the Colon & Rectum

7635. Predictive Factors of Mortality From Nonvariceal Upper Gastrointestinal Hemorrhage: A Multicenter Study. (Abstract)

Predictive Factors of Mortality From Nonvariceal Upper Gastrointestinal Hemorrhage: A Multicenter Study. From an Italian Registry of patients with upper gastrointestinal hemorrhage (UGIH), we assessed the clinical outcomes and explored the roles of clinical, endoscopic, and therapeutic factors on 30-day mortality in a real life setting.Prospective analysis of consecutive patients endoscoped for UGIH at 23 community and tertiary care institutions from 2003 to 2004. Covariates and outcomes were (...) defined a priori and 30-day follow-up obtained. Logistic regression analysis identified predictors of mortality.One thousand and twenty patients were included. A total of 46 patients died for an overall 4.5% mortality rate. In all, 85% of deaths were associated with one or more major comorbidity. Sixteen of 46 patients (35%) died within the first 24 h of the onset of bleeding. Of these, eight had been categorized as ASA class 1 or 2 and none of them was operated upon, despite a failure of endoscopic

2008 American Journal of Gastroenterology

7636. Enhanced gastric mucosal bleeding with doses of aspirin used for prophylaxis and its reduction by ranitidine. Full Text available with Trip Pro

) after 5 days and 1.6 (1.0-2.5 microliters 10 min-1) after 12 days (P less than 0.05). 3. Although these values were higher than control levels our results raise the possibility that coadministration of ranitidine may reduce the incidence of peptic ulceration and gastrointestinal haemorrhage which is increasingly reported in some subjects taking low dose aspirin for vascular prophylaxis. (...) Enhanced gastric mucosal bleeding with doses of aspirin used for prophylaxis and its reduction by ranitidine. 1. We evaluated injury to the human gastric mucosa caused by low doses of aspirin and its prophylaxis by ranitidine. On two separate occasions, 30 subjects took aspirin 300 mg daily for 12 days either with or without ranitidine 150 mg, 30 min before aspirin. This dose of aspirin caused more than a 5 fold increase in gastric bleeding, from control values of 0.5 microliters 10 min-1 (95

1989 British journal of clinical pharmacology Controlled trial quality: uncertain

7637. Extra-cranial bleeding and other symptoms due to low dose aspirin and low intensity oral anticoagulation. (Abstract)

of the trial is factorial, the four treatments being combined low dose aspirin and low intensity anticoagulation (WA), low intensity anticoagulation alone (W), low dose aspirin alone (A) and double placebo treatment (P). The trial is being carried out through the Medical Research Council's General Practice Research Framework, with participating practices throughout the United Kingdom. Results are based on the first 3,667 men entered. The risk of major gastrointestinal bleeding due to active treatment (...) Extra-cranial bleeding and other symptoms due to low dose aspirin and low intensity oral anticoagulation. Data from the early stages of the thrombosis prevention trial (TPT) have been used to establish and quantify the risk of extracranial bleeding due to low dose aspirin (75 mg) and low intensity oral anticoagulation with warfarin (international normalised ratio, INR, 1.5) singly or in combination, in men aged between 45 and 69 who are at high risk of ischaemic heart disease (IHD). The design

1992 Thrombosis and haemostasis Controlled trial quality: uncertain

7638. Aspirin use post-acute coronary syndromes: intolerance, bleeding and discontinuation. (Abstract)

were independently associated with early discontinuation. Early discontinuation was less likely in Eastern Europe, Latin America and Asia. Although major or minor bleeding was common (12.6%), only 1.0% of aspirin-treated patients were reported to discontinue due to bleeding. Gastrointestinal (10.5%) and puncture site (7.6%) were the most common bleeding locations. Bleeding risk was associated with lower estimated creatinine clearance, shorter time to treatment, smoking, Killip class >II, higher (...) systolic blood pressure, and use of aspirin or heparin prior to starting study aspirin.Despite early initiation and close follow-up, more than 9% of aspirin-treated patients discontinued therapy early and remained off treatment. Addressing the factors associated with both bleeding and discontinuation during chronic therapy is necessary to improve adherence to this inexpensive, life-saving therapy.

2003 Journal of thrombosis and thrombolysis Controlled trial quality: uncertain

7639. Risk of overt bleeding following aspirin. Full Text available with Trip Pro

Risk of overt bleeding following aspirin. 6969803 1981 03 17 2018 11 13 0141-0768 73 12 1980 Dec Journal of the Royal Society of Medicine J R Soc Med Risk of overt bleeding following aspirin. 895-6 Duggan J M JM eng Letter England J R Soc Med 7802879 0141-0768 R16CO5Y76E Aspirin IM Aspirin adverse effects Gastrointestinal Hemorrhage chemically induced Humans Risk 1980 12 1 1980 12 1 0 1 1980 12 1 0 0 ppublish 6969803 PMC1438244 N Engl J Med. 1974 May 23;290(21):1158-62 4545100 Lancet. 1978 Jul

1980 Journal of the Royal Society of Medicine

7640. Does adding misoprostol to standard intravenous proton pump inhibitor protocol improve the outcome of aspirin/NSAID-induced upper gastrointestinal bleeding?: a randomized prospective study. (Abstract)

Does adding misoprostol to standard intravenous proton pump inhibitor protocol improve the outcome of aspirin/NSAID-induced upper gastrointestinal bleeding?: a randomized prospective study. Aspirin and nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal bleeding is recognized as an important health problem. We performed a single-center randomized clinical trial to compare the effect of high-dose intravenous proton pump inhibitor (omeprazole) alone (group 1) with omeprazole (...) in combination with a low-dose prostaglandin analog (misoprostol; group 2) on clinical outcomes in patients with aspirin/NSAID-induced upper gastrointestinal bleeding. Additionally, we evaluated the contribution of Helicobacter pylori eradication therapy on the late consequences. Patients were recruited to the study if they had upper gastrointestinal bleeding with history of taking aspirin or other NSAIDs within the week before the onset of bleeding. All were evaluated in terms of probable risk factors

2007 Digestive diseases and sciences Controlled trial quality: uncertain

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