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

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

The benefits and harms of aspirin for people with type 2 diabetes are finely balanced Aspirin benefits and harms balanced in type 2 diabetes Dissemination Centre Discover Portal NIHR DC Discover The benefits and harms of aspirin for people with type 2 diabetes are finely balanced Published on 4 December 2018 doi: Daily aspirin reduced the risk of serious vascular events among people with diabetes, while increasing the risk of major bleeding to a similar extent. Aspirin prevented one person (...) in every 100 from having a heart attack or stroke over seven years, but an additional person per 100 experienced a major bleed. The ASCEND study is one of three large placebo-controlled trials investigating the effects of 100mg daily aspirin for primary prevention in people without established cardiovascular disease. However, unlike other trials (in healthy older adults), this study found that aspirin had no effect on cancer risk during the study period. The finding supports NICE recommendations

NIHR Dissemination Centre2018

2. Eicosapentaenoic acid and aspirin, alone and in combination, for the prevention of colorectal adenomas (seAFOod Polyp Prevention trial): a multicentre, randomised, double-blind, placebo-controlled, 2 × 2 factorial trial.

Eicosapentaenoic acid and aspirin, alone and in combination, for the prevention of colorectal adenomas (seAFOod Polyp Prevention trial): a multicentre, randomised, double-blind, placebo-controlled, 2 × 2 factorial trial. BACKGROUND: The omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) and aspirin both have proof of concept for colorectal cancer chemoprevention, aligned with an excellent safety profile. Therefore, we aimed to test the efficacy of EPA and aspirin, alone (...) in England, UK. Patients were randomly allocated (1:1:1:1) using a secure web-based server to receive 2 g EPA-free fatty acid (FFA) per day (either as the FFA or triglyceride), 300 mg aspirin per day, both treatments in combination, or placebo for 12 months using random permuted blocks of randomly varying size, and stratified by BCSP site. Research staff and participants were masked to group assignment. The primary endpoint was the adenoma detection rate (ADR; the proportion of participants with any

Lancet2018

3. AVURT: aspirin versus placebo for the treatment of venous leg ulcers a Phase II pilot randomised controlled trial

AVURT: aspirin versus placebo for the treatment of venous leg ulcers a Phase II pilot randomised controlled trial AVURT: aspirin versus placebo for the treatment of venous leg ulcers a Phase II pilot randomised controlled trial Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find (...) the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} This trial only recruited 27 of the target 100 participants with leg ulcers, due to many patients not meeting the eligibility criteria, and found no evidence that aspirin speeded up healing. {{author}} {{($index , , , , , , , , , , , , , , , , , , , , & . Helen Tilbrook 1 , Laura Clark 1 , Liz Cook 1 , Martin Bland 2 , Hannah Buckley 3 , Ian Chetter 4 , Jo Dumville 5 , Chris Fenner

NIHR HTA programme2018

4. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial 30274772 2018 10 27 1474-4465 2018 Sep 28 The Lancet. Neurology Lancet Neurol Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial. S1474-4422(18)30319-3 10.1016/S1474-4422(18)30319-3 Patent foramen ovale (PFO) is a contributor to embolic stroke (...) of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial. NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries

EvidenceUpdates2018

5. Misoprostol Heals Small Bowel Ulcers in Aspirin Users With Small Bowel Bleeding

Misoprostol Heals Small Bowel Ulcers in Aspirin Users With Small Bowel Bleeding 29966612 2018 10 23 2018 10 23 1528-0012 155 4 2018 10 Gastroenterology Gastroenterology Misoprostol Heals Small Bowel Ulcers in Aspirin Users With Small Bowel Bleeding. 1090-1097.e1 S0016-5085(18)34698-5 10.1053/j.gastro.2018.06.056 There is no effective treatment for aspirin-induced small bowel ulcer bleeding. We performed a double-blind, randomized, placebo-controlled trial to determine whether misoprostol can (...) heal small bowel ulcers in patients with small bowel bleeding who require continuous aspirin therapy. We performed a prospective study of 84 aspirin users with small bowel bleeding who required continued aspirin therapy in Hong Kong and Japan. Patients with small bowel ulcers or multiple erosions, detected by capsule endoscopy, were randomly assigned to groups that received either misoprostol (200 μg, 4 times daily; n = 42) or placebo (n = 42) for 8 weeks. All patients continued taking aspirin (100

EvidenceUpdates2018

6. Daily aspirin reduces pre-eclampsia for ‘at-risk’ women

Daily aspirin reduces pre-eclampsia for ‘at-risk’ women Signal - Daily aspirin reduces pre-eclampsia for ‘at-risk’ women Dissemination Centre Discover Portal NIHR DC Discover Daily aspirin reduces pre-eclampsia for ‘at-risk’ women Published on 24 January 2017 Starting daily low-dose aspirin before 16 weeks of pregnancy in women at risk reduces pre-eclampsia, severe pre-eclampsia and foetal growth restriction. Aspirin started after 16 weeks is less beneficial, giving smaller risk reduction (...) for pre-eclampsia and no effect on other outcomes. Defining who is ‘at risk’ remains challenging. Pre-eclampsia is a rare pregnancy complication, but one that can be dangerous for both mother and baby. Pregnant women are screened for pre-eclampsia risk factors at the antenatal booking appointment. NICE recommend women identified to be at risk are given preventative treatment with 75mg of aspirin from 12 weeks onwards. This large systematic review assessed doses between 50 and 150mg daily and suggests the higher

NIHR Dissemination Centre2018

7. Rivaroxaban plus aspirin may reduce heart attack and strokes in people with peripheral arterial disease, but with an added risk of bleeding

Rivaroxaban plus aspirin may reduce heart attack and strokes in people with peripheral arterial disease, but with an added risk of bleeding Signal - Rivaroxaban plus aspirin may reduce heart attack and strokes in people with peripheral arterial disease, but with an added risk of bleeding Dissemination Centre Discover Portal NIHR DC Discover Rivaroxaban plus aspirin may reduce heart attack and strokes in people with peripheral arterial disease, but with an added risk of bleeding Published on 14 (...) February 2018 People with peripheral arterial disease who took rivaroxaban plus aspirin daily over an average of 21 months reduced their risk of cardiovascular death, heart attack or stroke from seven to five in every 100 people treated compared with those given aspirin alone. The rivaroxaban plus aspirin group also reduced their risk of major limb problems or amputation but increased their risk of bleeding from one to two for every hundred people treated. Peripheral arterial disease is a condition

NIHR Dissemination Centre2018

8. Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy

Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Signal - Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Dissemination Centre Discover Portal NIHR DC Discover Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Published on 31 October 2017 Giving low dose aspirin to high-risk women reduced their risk of pre-eclampsia before 37 weeks of pregnancy. Preterm pre-eclampsia developed in 1.6% of women given 150mg aspirin daily (...) compared with 4.3% who took a placebo. Pre-eclampsia is a condition which can harm mother and baby. In the mother, it causes high blood pressure and protein in the urine, which can show in pregnancy after 20 weeks. Women with risk factors, such as previous pre-eclampsia, diabetes or high blood pressure, are often prescribed 75mg aspirin from 12 weeks onwards. This study aimed to test double this dose (still classified as a `low dose’) after using a new risk assessment with additional clinical tests

NIHR Dissemination Centre2018

9. Early aspirin reduces stroke recurrence following warning symptoms

Early aspirin reduces stroke recurrence following warning symptoms Signal - Early aspirin reduces stroke recurrence following warning symptoms Dissemination Centre Discover Portal NIHR DC Discover Early aspirin reduces stroke recurrence following warning symptoms Published on 7 July 2016 Aspirin taken as soon as possible after a stroke or symptoms of a stroke reduces the risk of further stroke within the next six weeks by about 60%. This is much better than the 13% reduction previously (...) estimated. People with warning strokes, where symptoms resolve within 24 hours, stand to benefit by self-administering aspirin even before a scan can be organised. This analysis of 12 large randomised controlled trials compared outcomes for adults taking aspirin, other drugs that prevent blood clots and no treatment. Aspirin importantly and significantly reduced the risk of early recurrent stroke in people with warning strokes and strokes perceived as less severe. The results support current

NIHR Dissemination Centre2018

10. Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery

Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery Dissemination Centre Discover Portal NIHR DC Discover Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery Published on 5 June 2018 In a recent trial, switching to low-dose aspirin was just as effective at preventing blood clots after joint (...) replacement surgery as continuing the anti-clotting drug rivaroxaban. Six per 1,000 people taking aspirin experienced a blood clot, compared with seven per 1,000 taking rivaroxaban. Three to five per 1,000 patients experienced major bleeding with either drug. Rivaroxaban or similar drugs are usually prescribed for two or five weeks after knee or hip surgery, respectively, to reduce the risk of blood clots in the legs or lungs. This trial included over 3,000 adults who received rivaroxaban for the first

NIHR Dissemination Centre2018

11. Low-dose aspirin is associated with reduced spontaneous preterm birth in nulliparous women

Low-dose aspirin is associated with reduced spontaneous preterm birth in nulliparous women 29913174 2018 10 01 1097-6868 219 4 2018 Oct American journal of obstetrics and gynecology Am. J. Obstet. Gynecol. Low-dose aspirin is associated with reduced spontaneous preterm birth in nulliparous women. 399.e1-399.e6 S0002-9378(18)30498-8 10.1016/j.ajog.2018.06.011 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

EvidenceUpdates2018

12. Hydroxycarbamide Plus Aspirin Versus Aspirin Alone in Patients With Essential Thrombocythemia Age 40 to 59 Years Without High-Risk Features

Hydroxycarbamide Plus Aspirin Versus Aspirin Alone in Patients With Essential Thrombocythemia Age 40 to 59 Years Without High-Risk Features 30153096 2018 08 28 1527-7755 2018 Aug 28 Journal of clinical oncology : official journal of the American Society of Clinical Oncology J. Clin. Oncol. Hydroxycarbamide Plus Aspirin Versus Aspirin Alone in Patients With Essential Thrombocythemia Age 40 to 59 Years Without High-Risk Features. JCO2018788414 10.1200/JCO.2018.78.8414 Purpose Cytoreductive (...) therapy is beneficial in patients with essential thrombocythemia (ET) at high risk of thrombosis. However, its value in those lacking high-risk features remains unknown. This open-label, randomized trial compared hydroxycarbamide plus aspirin with aspirin alone in patients with ET age 40 to 59 years and without high-risk factors or extreme thrombocytosis. Patients and Methods Patients were age 40 to 59 years and lacked a history of ischemia, thrombosis, embolism, hemorrhage, extreme thrombocytosis

EvidenceUpdates2018

13. Effect of Aspirin on All-Cause Mortality in the Healthy Elderly.

Effect of Aspirin on All-Cause Mortality in the Healthy Elderly. Background 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. Methods 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

NEJM2018

14. Effect of Aspirin on Disability-free Survival in the Healthy Elderly.

Effect of Aspirin on Disability-free Survival in the Healthy Elderly. Background 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. Methods 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. Results A total of 19,114 persons with a median age of 74 years were enrolled, of whom

NEJM2018

15. Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly.

Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. Background 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. Methods 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

NEJM2018

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

Effect of aspirin in vascular surgery in patients from a randomized clinical trial (POISE-2) 30019751 2018 07 18 1365-2168 2018 Jul 18 The British journal of surgery Br J Surg Effect of aspirin in vascular surgery in patients from a randomized clinical trial (POISE-2). 10.1002/bjs.10925 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

EvidenceUpdates2018

18. Efficacy and Safety of Ticagrelor in Relation to Aspirin Use Within the Week Before Randomization in the SOCRATES Trial

Efficacy and Safety of Ticagrelor in Relation to Aspirin Use Within the Week Before Randomization in the SOCRATES Trial 29915123 2018 06 29 1524-4628 49 7 2018 Jul Stroke Stroke Efficacy and Safety of Ticagrelor in Relation to Aspirin Use Within the Week Before Randomization in the SOCRATES Trial. 1678-1685 10.1161/STROKEAHA.118.020553 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

EvidenceUpdates2018

19. Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus.

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; the balance of benefits and hazards for the prevention of first cardiovascular events in patients with diabetes is unclear. Methods We randomly assigned adults who had diabetes but no evident cardiovascular disease to receive aspirin at (...) cancer. Results A total 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

NEJM2018

20. 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

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 BACKGROUND: 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. METHODS: 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

Lancet2018