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

361. Economic assessment of the secondary prevention of ischaemic stroke with dipyridamole plus aspirin (Aggrenox/Asasantin) in France

Economic assessment of the secondary prevention of ischaemic stroke with dipyridamole plus aspirin (Aggrenox/Asasantin) in France Economic assessment of the secondary prevention of ischaemic stroke with dipyridamole plus aspirin (Aggrenox/Asasantin) in France Economic assessment of the secondary prevention of ischaemic stroke with dipyridamole plus aspirin (Aggrenox/Asasantin) in France Marissal J P, Selke B, Amarenco P Record Status This is a critical abstract of an economic evaluation (...) that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of aspirin 25 mg plus dipyridamole 200 mg, twice daily, for the secondary prevention of ischaemic stroke. Type of intervention Secondary prevention. Economic study type Cost-effectiveness analysis. Study population The study population comprised

NHS Economic Evaluation Database.2004

362. Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST-segment-elevation acute coronary syndromes: a systematic review and economic evaluation

Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST-segment-elevation acute coronary syndromes: a systematic review and economic evaluation Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST-segment-elevation acute coronary syndromes: a systematic review and economic evaluation Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST-segment-elevation acute (...) the use of 12-month clopidogrel in combination with aspirin for the prevention of morbidity and mortality associated with non-ST-segment elevation acute coronary syndrome (ACS). The combined therapy was compared with standard therapy including aspirin. Three alternative strategies (representing treatment with clopidogrel over a 1-, 3- or 6-month duration) were also considered. Type of intervention Secondary prevention. Economic study type Cost-utility analysis Study population The study population

NHS Economic Evaluation Database.2004

363. Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST-segment-elevation acute coronary syndromes: a systematic review and economic evaluation

Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST-segment-elevation acute coronary syndromes: a systematic review and economic evaluation Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST-segment-elevation acute coronary syndromes: a systematic review and economic evaluation Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST-segment-elevation acute (...) coronary syndromes: a systematic review and economic evaluation Main C, Palmer S, Griffin S, Jones L, Orton V, Sculpher M, et al Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Main C, Palmer S, Griffin S, Jones L, Orton V, Sculpher M, et al. Clopidogrel used in combination with aspirin compared with aspirin alone in the treatment of non-ST

Health Technology Assessment (HTA) Database.2004

364. Safety and efficacy of enoxaparin vs unfractionated heparin in patients with non-ST-segment elevation acute coronary syndromes who receive tirofiban and aspirin: a randomized controlled trial.

Safety and efficacy of enoxaparin vs unfractionated heparin in patients with non-ST-segment elevation acute coronary syndromes who receive tirofiban and aspirin: a randomized controlled trial. 15238591 2004 07 07 2004 07 13 2016 10 17 1538-3598 292 1 2004 Jul 07 JAMA JAMA Safety and efficacy of enoxaparin vs unfractionated heparin in patients with non-ST-segment elevation acute coronary syndromes who receive tirofiban and aspirin: a randomized controlled trial. 55-64 Enoxaparin (...) compared with unfractionated heparin and tirofiban in patients with non-ST-elevation ACS. A prospective, international, open-label, randomized, noninferiority trial of 1 mg/kg of enoxaparin every 12 hours (n = 2026) compared with weight-adjusted intravenous unfractionated heparin (n = 1961) in patients with non-ST-elevation ACS receiving tirofiban and aspirin. Phase A of the A to Z trial was conducted between December 1999 and May 2002. Death, recurrent myocardial infarction, or refractory ischemia

JAMA2004

365. Efficacy and safety of low-dose aspirin in polycythemia vera.

Efficacy and safety of low-dose aspirin in polycythemia vera. 14711910 2004 01 08 2004 01 16 2013 11 21 1533-4406 350 2 2004 Jan 08 The New England journal of medicine N. Engl. J. Med. Efficacy and safety of low-dose aspirin in polycythemia vera. 114-24 The use of aspirin for the prevention of thrombotic complications in polycythemia vera is controversial. We enrolled 518 patients with polycythemia vera, no clear indication for aspirin treatment, and no contraindication to such treatment (...) in a double-blind, placebo-controlled, randomized trial to assess the safety and efficacy of prophylaxis with low-dose aspirin (100 mg daily). The two primary end points were the cumulative rate of nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes and the cumulative rate of nonfatal myocardial infarction, nonfatal stroke, pulmonary embolism, major venous thrombosis, or death from cardiovascular causes. The mean duration of follow-up was about three years. Treatment

NEJM2004

366. Non steroidal anti-inflammatory drugs (NSAID) and Aspirin for preventing colorectal adenomas and carcinomas.

Non steroidal anti-inflammatory drugs (NSAID) and Aspirin for preventing colorectal adenomas and carcinomas. BACKGROUND: There is evidence from experimental animals studies, prospective and retrospective observational studies that nonsteroidal anti-inflammatory drugs (NSAIDS) may reduce the development of sporadic colorectal adenomas (CRAs) and cancer (CRC) and may induce the regression of adenomas in familial adenomatous polyposis (FAP). OBJECTIVES: To conduct a systematic review to determine (...) the effect of NSAIDS for the prevention or regression of CRAs and CRC. SEARCH STRATEGY: Randomized controlled trials (RCTs) up to September 2003 were identified. SELECTION CRITERIA: NSAIDS and aspirin (ASA) were the interventions. The primary outcomes were the number of subjects with at least one CRA, the change in polyp burden, and CRC. The secondary outcome was adverse events. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed trial quality. Dichotomous outcomes were

Cochrane2004

367. Effect of ibuprofen on cardioprotective effect of aspirin.

Effect of ibuprofen on cardioprotective effect of aspirin. Treatment with ibuprofen might limit the cardioprotective effects of aspirin. We aimed to assess whether patients with known cardiovascular disease who take low-dose aspirin and ibuprofen have increased risk of cardiovascular mortality. We studied 7107 patients who were discharged after first admission for cardiovascular disease between April, 1989, and April, 1997, and who were prescribed low-dose aspirin (<325 mg/day) and survived (...) for at least 1 month. Compared with those who used aspirin alone, patients taking aspirin plus ibuprofen had an increased risk of all-cause mortality (adjusted hazard ratio 1.93, 95% CI 1.30-2.87, p=0.0011) and cardiovascular mortality (1.73, 1.05-2.84, p=0.0305). Our finding lends support to the hypothesis that ibuprofen may interact with the cardioprotective effects of aspirin, at least in patients with established cardiovascular disease.

Lancet2003

368. Indirect comparison meta-analysis of aspirin therapy after coronary surgery

Indirect comparison meta-analysis of aspirin therapy after coronary surgery Indirect comparison meta-analysis of aspirin therapy after coronary surgery Indirect comparison meta-analysis of aspirin therapy after coronary surgery Lim E, Ali Z, Ali A, Routledge T, Edmonds L, Altman D G, Large S CRD summary This review evaluated the efficacy of low and medium dose aspirin therapy after coronary surgery. Limited evidence showed that medium-dose aspirin may more successfully reduce graft occlusion (...) than low-dose regimens in the first year after coronary surgery. No formal exploration of the differences between included studies is reported, and without this the results should be interpreted with caution. Authors' objectives To evaluate the efficacy of low- and medium-dose aspirin therapy on graft patency after coronary surgery by using an indirect comparison meta-analysis. Searching MEDLINE (from 1966 to April 2003) and EMBASE (from 1974 to week 17, 2003) were searched; the search terms were

DARE.2003

369. An update on aspirin in the primary prevention of cardiovascular disease

An update on aspirin in the primary prevention of cardiovascular disease An update on aspirin in the primary prevention of cardiovascular disease An update on aspirin in the primary prevention of cardiovascular disease Eidelman R S, Herbert P R, Wiesman S M, Hennekens C H CRD summary This review assessed the use of aspirin in the primary prevention of cardiovascular disease. Strong support was found for aspirin preventing a first heart attack in apparently healthy individuals. Evidence (...) on strokes or vascular deaths failed to yield conclusive results. Although review methods were poorly reported, the authors' conclusions appear supported by the evidence presented. Authors' objectives To review the evidence of aspirin in the primary prevention of cardiovascular disease (CVD). Searching The authors stated that they performed a computerised literature search of the English literature from 1988 to present. No other information was given. Study selection Study designs of evaluations included

DARE.2003

370. Effects of aspirin consumption during pregnancy on pregnancy outcomes: meta-analysis

Effects of aspirin consumption during pregnancy on pregnancy outcomes: meta-analysis Effects of aspirin consumption during pregnancy on pregnancy outcomes: meta-analysis Effects of aspirin consumption during pregnancy on pregnancy outcomes: meta-analysis Kozer E, Costei A M, Boskovic R, Nulman I, Nikfar S, Koren G CRD summary The review assessed the safety of aspirin during pregnancy. The authors concluded that aspirin reduced the rate of pre-term deliveries, but not perinatal death, in women (...) with moderate to high-risk pregnancies. The authors' conclusions seem appropriate. However, the lack of detail about the methodology of the review makes the reliability of the conclusions uncertain. Authors' objectives To assess the safety of aspirin treatment during pregnancy in relation to foetal and neonatal outcomes. Searching MEDLINE (from 1966 to April 2001), EMBASE (from 1980 to 2000), TOXLINE (from 1994 to 2000), EBM Reviews, and the Cochrane Database of Systematic Reviews (1991 to 2000) were

DARE.2003

371. Aspirin for prevention of preeclampsia in women with historical risk factors: a systematic review

Aspirin for prevention of preeclampsia in women with historical risk factors: a systematic review Aspirin for prevention of preeclampsia in women with historical risk factors: a systematic review Aspirin for prevention of preeclampsia in women with historical risk factors: a systematic review Coomarasamy A, Honest H, Papaioannou S, Gee H, Khan K S CRD summary This review examined the effectiveness of aspirin in preventing perinatal death and pre-eclampsia in women with predisposing factors (...) . The authors concluded that aspirin can reduce the risk of pre-eclampsia and perinatal death in women who have known historical risk factors. Statements on the safety of aspirin were derived largely from observational studies, which were not part of the current systematic review. Authors' objectives To examine the effectiveness of aspirin in preventing perinatal death and pre-eclampsia in women with predisposing factors. Searching MEDLINE (from 1966 to 2001), EMBASE (from 1980 to 2001), the Cochrane

DARE.2003

372. Cost-effectiveness analysis of clopidogrel versus aspirin in patients with atherothrombosis based on the CAPRIE trial

Cost-effectiveness analysis of clopidogrel versus aspirin in patients with atherothrombosis based on the CAPRIE trial Cost-effectiveness analysis of clopidogrel versus aspirin in patients with atherothrombosis based on the CAPRIE trial Cost-effectiveness analysis of clopidogrel versus aspirin in patients with atherothrombosis based on the CAPRIE trial Annemans L, Lamotte M, Levy E, Lenne X Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion (...) symptomatic PAD. The mean age was 62.5 years. There were 9,553 patients in the clopidogrel group and 9,546 in the aspirin group. Additional information was taken from the CAPRIE study. Study design The study was an international, multi-centre, randomised controlled trial, with an average follow-up of 1.91 years. A total of 384 clinical centres from 16 countries participated. The patients were randomised to either 75-mg tablets of clopidogrel plus aspirin placebo or 325-mg tablets of aspirin plus

NHS Economic Evaluation Database.2003

373. Aspirin and ticlopidine for prevention of recurrent stroke in black patients: a randomized trial.

Aspirin and ticlopidine for prevention of recurrent stroke in black patients: a randomized trial. 12799402 2003 06 11 2003 07 07 2016 10 17 1538-3598 289 22 2003 Jun 11 JAMA JAMA Aspirin and ticlopidine for prevention of recurrent stroke in black patients: a randomized trial. 2947-57 Blacks are disproportionately affected by stroke, and they are about 2 times more likely than most other individuals in the United States to die of or experience stroke. To determine the efficacy and safety (...) of aspirin and ticlopidine to prevent recurrent stroke in black patients. Randomized, double-blind, investigator-initiated, multicenter trial of 1809 black men and women who recently had a noncardioembolic ischemic stroke and who were recruited between December 1992 and October 2001 from 62 academic and community hospitals in the United States and followed up for up to 2 years. A total of 902 patients received 500 mg/d of ticlopidine and 907 received 650 mg/d of aspirin. Recurrent stroke, myocardial

JAMA2003

374. A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer.

A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. 12621132 2003 03 06 2003 03 17 2014 11 20 1533-4406 348 10 2003 Mar 06 The New England journal of medicine N. Engl. J. Med. A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. 883-90 Experimental studies in animals and observational studies in humans suggest that regular aspirin use may decrease the risk of colorectal adenomas (...) , the precursors to most colorectal cancers. We conducted a randomized, double-blind trial to determine the effect of aspirin on the incidence of colorectal adenomas. We randomly assigned 635 patients with previous colorectal cancer to receive either 325 mg of aspirin per day or placebo. We determined the proportion of patients with adenomas, the number of recurrent adenomas, and the time to the development of adenoma between randomization and subsequent colonoscopic examinations. Relative risks were adjusted

NEJM2003

375. A randomized trial of aspirin to prevent colorectal adenomas.

A randomized trial of aspirin to prevent colorectal adenomas. 12621133 2003 03 06 2003 03 17 2014 11 20 1533-4406 348 10 2003 Mar 06 The New England journal of medicine N. Engl. J. Med. A randomized trial of aspirin to prevent colorectal adenomas. 891-9 Laboratory and epidemiologic data suggest that aspirin has an antineoplastic effect in the large bowel. We performed a randomized, double-blind trial of aspirin as a chemopreventive agent against colorectal adenomas. We randomly assigned 1121 (...) patients with a recent history of histologically documented adenomas to receive placebo (372 patients), 81 mg of aspirin (377 patients), or 325 mg of aspirin (372 patients) daily. According to the protocol, follow-up colonoscopy was to be performed approximately three years after the qualifying endoscopy. We compared the groups with respect to the risk of one or more neoplasms (adenomas or colorectal cancer) at least one year after randomization using generalized linear models to compute risk ratios

NEJM2003

376. Leukotriene-receptor expression on nasal mucosal inflammatory cells in aspirin-sensitive rhinosinusitis.

Leukotriene-receptor expression on nasal mucosal inflammatory cells in aspirin-sensitive rhinosinusitis. BACKGROUND: Patients with asthma who have aspirin sensitivity have greater cysteinyl leukotriene production and greater airway hyperresponsiveness to the effects of inhaled cysteinyl leukotrienes than their aspirin-tolerant counterparts. We hypothesized that the latter effect reflects elevated expression of the cysteinyl leukotriene receptor CysLT1 on inflammatory cells in the target organ (...) and that its expression is down-regulated by aspirin desensitization. METHODS: We obtained nasal-biopsy specimens from 22 aspirin-sensitive and 12 non-aspirin-sensitive patients with chronic rhinosinusitis and nasal polyps. Additional specimens were then obtained from subgroups of the aspirin-sensitive patients after intranasal application of lysine aspirin or placebo for two weeks (five and four patients, respectively) or for six months (five and four patients, respectively). The numbers of leukocytes

NEJM2002

377. Aspirin and mortality from coronary bypass surgery.

Aspirin and mortality from coronary bypass surgery. BACKGROUND: There is no therapy known to reduce the risk of complications or death after coronary bypass surgery. Because platelet activation constitutes a pivotal mechanism for injury in patients with atherosclerosis, we assessed whether early treatment with aspirin could improve survival after coronary bypass surgery. METHODS: At 70 centers in 17 countries, we prospectively studied 5065 patients undergoing coronary bypass surgery, of whom (...) 5022 survived the first 48 hours after surgery. We gathered data on 7500 variables per patient and adjudicated outcomes centrally. The primary focus was to discern the relation between early aspirin use and fatal and nonfatal outcomes. RESULTS: During hospitalization, 164 patients died (3.2 percent), and 812 others (16.0 percent) had nonfatal cardiac, cerebral, renal, or gastrointestinal ischemic complications. Among patients who received aspirin (up to 650 mg) within 48 hours after

NEJM2002

378. Cost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart disease.

Cost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart disease. BACKGROUND: Both aspirin and clopidogrel reduce the rate of cardiovascular events in patients with coronary heart disease. We estimated the cost effectiveness of the increased use of aspirin, clopidogrel, or both for secondary prevention in patients with coronary heart disease. METHODS: We used the Coronary Heart Disease Policy Model, a computer simulation of the U.S. population, to estimate (...) the incremental cost effectiveness (in dollars per quality-adjusted years of life gained) of four strategies in patients over 35 years of age with coronary disease from 2003 to 2027: aspirin for all eligible patients (i.e., those who were not allergic to or intolerant of aspirin), aspirin for all eligible patients plus clopidogrel for patients who were ineligible for aspirin, clopidogrel for all patients, and the combination of aspirin for all eligible patients plus clopidogrel for all patients. RESULTS

NEJM2002

379. Aspirin for the primary prevention of cardiovascular events: recommendation and rationale.

Aspirin for the primary prevention of cardiovascular events: recommendation and rationale. This statement summarizes the recommendation of the third U.S. Preventive Services Task Force (USPSTF) for aspirin for the primary prevention of cardiovascular events, as well as the supporting scientific evidence. The complete information on which this statement is based, including evidence tables and references, can be found in a companion article in this issue. Copies of this document, the summary

Annals of Internal Medicine2002

380. Aspirin in diabetic retinopathy: a systematic review

Aspirin in diabetic retinopathy: a systematic review Aspirin in diabetic retinopathy: a systematic review Aspirin in diabetic retinopathy: a systematic review Bergerhoff K, Clar C, Richter B Authors' objectives To assess the impact of aspirin alone and in combination with other antiplatelet agents on the progression of diabetic retinopathy. Searching The Cochrane Library (including the Cochrane Controlled Trials Register) and MEDLINE were searched up to 2001. Study selection Study designs (...) of evaluations included in the review Only randomised controlled trials (RCTs) were eligible for inclusion. Specific interventions included in the review Studies of aspirin alone versus placebo, or aspirin in combination with dipyridamole versus placebo, were eligible for inclusion. Aspirin alone was used in two of the included studies, while in one study aspirin alone was compared with aspirin-dipyridamole. The aspirin dosage ranged from 650 to 990 mg/day; the dipyridamole dosage was 225 mg/day. All

DARE.2002