Aspirin
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Aspirin
General Information
NEWS:
Aspirin Prevents Antibiotic-Linked Hearing Loss
Aspirin Protects Men and Women Differently
Aspirin use not seen linked to stroke severity
Conflict of interest highlighted in aspirin-resistance debate "The issue of expert opinion being potentially influenced by corporate research funding has again been highlighted—this time in an article on aspirin resistance in the Wall Street Journal [1]. The article, published on April 24, 2006, reports that much of the discussion of aspirin resistance has been instigated by doctors receiving research funds from companies making competitors to aspirin or tests for aspirin resistance. … The main drug to benefit from reports of aspirin resistance is clopidogrel (Plavix, Bristol-Myers Squibb/Sanofi-Aventis), worldwide sales of which reached $5.9 billion last year, the article notes. It quotes Dr Sanjay Kaul (Cedars-Sinai Medical Center, Los Angeles, CA) as saying: "Before Plavix we rarely heard a mention of aspirin resistance. One has to wonder if the commercial implications of this phenomenon trump scientific reality." But Bristol-Myers Squibb is reported as denying seeking to undermine aspirin. … Topol says the Wall Street Journal article was unfair [2]. In a letter published in the Journal two days later (April 26, 2006), he complains that he was unjustly targeted in the article …"
Ibuprofen curbs aspirin's anti-clotting action "There is a drug-drug interaction between ibuprofen and aspirin, with ibuprofen affecting aspirin's ability to inhibit platelet clumping or aggregation that can lead to fatal blood clots …"
ARTICLES:
Myocardial infarction: aspirin, NSAIDs, and COXIBs
JOURNAL ARTICLES:
A randomised controlled trial of warfarin versus aspirin for stroke prevention in octogenarians with atrial fibrillation (WASPO). (Age Ageing. 2006) "CONCLUSION: dose-adjusted warfarin was significantly better tolerated with fewer adverse events than aspirin 300 mg in this elderly population. Although aspirin 75 mg may have been better tolerated, there is no evidence for efficacy in AF at this dose."
Aspirin for the primary prevention of cardiovascular events. (Drugs Today (Barc). 2006)
Aspirin for the Primary Prevention of Cardiovascular Events in Women and Men (JAMA. 2006)
Aspirin in the prevention and treatment of venous thromboembolism. (J Thromb Haemost. 2006) "Currently, there is no evidence to support a role for aspirin in air travel-related VTE."
Aspirin overprescription in primary cardiovascular prevention (Thrombosis Research 2006) "A non-negligible proportion–up to 18%–of subjects in primary prevention is currently more likely to derive harm than benefit from inappropriate aspirin use."
Aspirin prevents stroke but not MI in women; vitamin E has no effect on CV disease or cancer. (leve Clin J Med. 2006) "Analysis of secondary cardiovascular end points revealed that aspirin use was associated with no significant effect on the number of total MIs, fatal MIs, and nonfatal MIs, and a nonsignificant decrease in cardiovascular mortality. However, aspirin users did experience significantly fewer strokes, in particular ischemic strokes. Vitamin E had very little impact on the primary prevention of both"
Aspirin prophylaxis and the prevalence of anaemia. (Age Ageing. 2006) "CONCLUSIONS: chronic low-dose aspirin use amongst an elderly cohort was associated with increased likelihood of normal haemoglobin."
Aspirin reduces risk of cardiovascular events, increases risk of bleeding (Cleveland Clinic Journal of Medicine)
Aspirin resistance: definitions, mechanisms, prevalence, and clinical significance. (Curr Pharm Des. 2006)
Aspirin resistance - does it clinically matter? (Clin Res Cardiol. 2006)
Aspirin resistance: is this term meaningful? (Curr Opin Hematol. 2006) "PURPOSE OF REVIEW: To review data for and against the existence of 'aspirin resistance', a term coined to indicate aspirin-treated patients having ex-vivo tests of platelet activation insensitive to aspirin treatment and recurrence of cardiovascular disease."
Aspirin to Prevent Heart Attack and Stroke: What’s the Right Dose? (The American Journal of Medicine 2006)
Biological efficacy of low versus medium dose aspirin after coronary surgery: results from a randomized trial [NCT00262275]. (BMC Med. 2006) "CONCLUSIONS: Contrary to recent findings, low dose aspirin is effective and medium dose aspirin did not prove superior for inhibiting platelet aggregation after coronary surgery."
Chronic Aspirin Therapy for the Prevention of Cardiovascular Events: A Waste of Time, or Worse? (Nat Clin Pract Cardiovasc Med. 2006) "Few therapies in cardiovascular medicine have been studied so intently and adopted so widely into clinical practice as aspirin, especially with so little evidence of long-term benefit for people with or at risk of coronary artery disease. A series of studies has shown that long-term aspirin therapy is ineffective, or worse, for the primary, secondary or tertiary prevention of cardiovascular events; however, distorted reporting of these studies, in a way that would not be tolerated for other pharmacologic agents, has led many readers to misinterpret neutral studies as showing benefit with aspirin (see Supplementary Table 1 online for a list of these investigations). … Aspirin should be used to treat or prevent medical problems only when the effective dose and duration of therapy is known—that is, for short-term treatment of acute vascular events and relief of pain. Aspirin should not be given to patients to achieve misguided health-service targets. International guidelines now recommend aspirin withdrawal in some patients with coronary disease, and such recommendations should be extended to other patient groups after scientific review of the relevant evidence.[1]"
Effect of Enteric Coating on Antiplatelet Activity of Low-Dose Aspirin in Healthy Volunteers (Stroke. 2006) "Conclusions— Equivalent doses of the enteric-coated aspirin were not as effective as plain aspirin. Lower bioavailability of these preparations and poor absorption from the higher pH environment of the small intestine may result in inadequate platelet inhibition, particularly in heavier subjects."
Impact of aspirin therapy in cancer patients with thrombocytopenia and acute coronary syndromes. (Cancer. 2006) "CONCLUSIONS.: Therapy with ASA was associated with a significantly improved 7-day survival after ACS in cancer patients, with or without thrombocytopenia, and not associated with more severe bleeding."
Lack of effect of enteric coating on aspirin-induced inhibition of platelet aggregation in healthy volunteers. (Am Heart J. 2006) "CONCLUSIONS: Compared with standard aspirin, EC aspirin appears to exhibit similar inhibition of platelet aggregation in healthy volunteers."
Long-term anticoagulant therapy in patients with coronary artery disease. (Eur Heart J. 2006)
Long-term aspirin use and colorectal cancer risk: a cohort study in Sweden. (Br J Cancer. 2006) " … long duration of aspirin use (>20 years) was associated with a reduced risk of colorectal cancer …"
Low-dose aspirin and cancer (Bandolier Journal 2006) "Comment: This is an important trial because it tests an important hypothesis in a large number of women over a long period of time, and with a sufficient number of events to be sure of the result. In people with no history of cancer, low-dose aspirin does not prevent cancer. Low dose aspirin is not without harm, however, so on balance in these patients it probably does more harm than good."
Low-Dose Aspirin for Prevention of Stroke in Low-Risk Patients With Atrial Fibrillation (Stroke. 2006)
Management of high-risk patients on non-steroidal anti-inflammatory drugs or aspirin. (Drugs. 2006) "Evidence emerged recently that COX-2 inhibitors and some non-selective NSAID increase cardiovascular risk. Before prescribing anti-inflammatory therapy, both gastrointestinal and cardiovascular risk factors of individual patients need to be evaluated. In patients with increased cardiovascular risk requiring anti-inflammatory analgesics, the combination of a non-selective NSAID, low-dose aspirin and a PPI is the preferred treatment."
Oral anticoagulants versus antiplatelet therapy for preventing further vascular events after transient ischaemic attack or minor stroke of presumed arterial origin. (Cochrane Database Syst Rev. 2006) "BACKGROUND: Patients with limited cerebral ischaemia of arterial origin have an annual risk of major vascular events between 4% and 11%. Aspirin reduces this risk by 20% at most. Secondary prevention trials after myocardial infarction indicate that treatment with oral anticoagulants is associated with a risk reduction approximately twice that of treatment with antiplatelet therapy. … AUTHORS' CONCLUSIONS: For secondary prevention of further vascular events after limited ischaemic stroke of arterial origin, there is insufficient evidence to justify the routine use of medium-intensity oral anticoagulants; such treatment should only be used as part of a clinical trial. More intense anticoagulation is not safe and should not be used in this setting. Low-intensity anticoagulation is not likely to be more or less efficacious than aspirin."
Previous Use of Aspirin and Baseline Stroke Severity: An Analysis of 17 850 Patients in the International Stroke Trial (Stroke 2006) "Conclusions— In this large prospective and complete data set, we found no evidence of any association of previous aspirin use with baseline stroke severity. The analyses suggest that previously reported positive and negative associations may well have been attributable to the play of chance in small samples, confounding or other biases, rather than a biological effect of aspirin."
Regular aspirin use and esophageal cancer risk. (Int J Cancer. 2006)
Regular aspirin-use preceding the onset of primary intracerebral hemorrhage is an independent predictor for death. (Stroke. 2006)
Regular use of aspirin and prostate cancer risk (United States). (Cancer Causes Control. 2006)
Systematic review and meta-analysis of adverse events of low-dose aspirin and clopidogrel in randomized controlled trials. (Am J Med. 2006)
The Association between Aspirin Use and the Incidence of Colorectal Cancer in Women. (Am J Epidemiol. 2006) "… There was no significant association between any aspirin use and risk for incident colorectal cancer …"
The dose of aspirin for the prevention of cardiovascular and cerebrovascular events. (Curr Med Res Opin. 2006)
Variation and importance of aspirin resistance in patients with known cardiovascular disease. (Thromb Res. 2006) "Conclusion: The prevalence of aspirin resistance varies with the clinical status of the patients, and indeed an acute MI is associated with temporary aspirin resistance. We also found that 6% of patients demonstrate persistent aspirin resistance. The presence of aspirin resistance did not affect one-year clinical outcome."
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