Aspirin
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Aspirin
General Information
NEWS:
An aspirin a day for Alzheimer's disease
Aspirin can relieve acute migraine
Aspirin for Women: Yes or No? "Women who regularly took high-dose aspirin … more than 14 adult-strength tablets a week -- did not get a health benefit. Instead, they were 43% more likely to die from hemorrhagic stroke compared with those who never took aspirin. Hemorrhagic stroke is stroke due to bleeding in the brain … Older women and women with pre-existing risk factors for heart disease got the largest benefit from regular low- or moderate-dose aspirin. … "There are suggestions here that there is a subgroup of women for whom regular aspirin makes sense," Chan tells WebMD. "But no one should take aspirin therapy on her own. This still requires a thorough discussion of individual risks and benefits with a doctor." … "These new findings by Chan et al. cannot overcome the accumulated evidence that aspirin is not particularly effective for the primary prevention of death from cardiovascular disease in women," Baron and colleagues note."
Aspirin may lower death risk in women "Aspirin in low to moderate doses may lower the risk of death in women, particularly those who are older and prone to heart disease, a 24-year study of nearly 80,000 women suggests. However, experts cautioned that the results are not definitive and that women should not take aspirin as a health preventive without talking to their doctor. In this long-running study of nurses who were middle-aged and older, women who took aspirin had a 25 percent lower risk of death compared with those who never took it. Aspirin-takers had a 38 percent lower risk of death from cardiovascular disease and a 12 percent lower risk of death from cancer. "
Aspirin May Prevent New Adult-Onset Asthma "Results from the Physicians Health Study indicate that regular aspirin use may reduce the risk of new-onset asthma in adults by 22%. However, there is no evidence that aspirin improves symptoms in subjects who already have asthma, and it may of course cause acute bronchospasm among individuals with aspirin-intolerant asthma."
Aspirin Prevents Only COX-2-Positive Colorectal Cancer "The effect of aspirin (acetylsalicylic acid) in preventing colorectal cancer is restricted only to tumors that are COX-2-postive, a new analysis concludes. Taking aspirin significantly reduced the risk of developing COX-2-positive colorectal cancer, but not COX-1-positive colorectal cancer, researchers conclude in the May 24 issue of the New England Journal of Medicine."
Aspirin Reduces Nonfatal MI in Studies of Men, but not in Trials Dominated by Women "A new meta-analysis adds heft to concerns that aspirin does not benefit women in the same way it does men [1]; however, experts not involved in the study caution that the new research should not in any way change how physicians currently prescribe aspirin to women."
Enteric coating may not protect stomach "Enteric-coated aspirin has virtually the same effect on the stomach as plain, uncoated aspirin, according to a U.S. newsletter. The Harvard Heart Letter explains that aspirin doesn't have to be in contact with stomach cells to harm them."
Study: 43 million Americans take aspirin daily "Most are taking the pills for their health -- such as to prevent heart attacks or strokes -- the Agency for Healthcare Research and Quality found."
ARTICLES:
AHRQ - Aspirin or Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of Colorectal Cancer (2007) "The USPSTF recommends against the routine use of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) to prevent colorectal cancer in individuals at average risk for colorectal cancer."
Daily Aspirin Therapy "Should I take a coated aspirin? Enteric-coated aspirin is designed to pass through your stomach and not disintegrate until it reaches your intestines. As such, it's less erosive to the stomach and may be appropriate for some people who take a daily aspirin, especially in those with a history of gastritis or ulcers. However, it takes longer for your body to absorb enteric-coated aspirin. Also, it doesn't appear to offer significant protection against gastrointestinal bleeding. In addition, some research suggests that enteric-coated aspirin may actually be less potent than plain aspirin. So, a dose of enteric-coated aspirin could have less beneficial effect on blood than an equivalent dose of plain aspirin has. More studies are needed to better understand the therapeutic differences between plain aspirin and enteric-coated aspirin. If you have questions or concerns about the type of aspirin you take, consult your doctor to determine the best option for you."
JOURNAL ARTICLES:
A comparison of six major platelet function tests to determine the prevalence of aspirin resistance in patients with stable coronary artery disease. (Eur Heart J. 2007)
A Large Cohort Study of Long-Term Daily Use of Adult-Strength Aspirin and Cancer Incidence (Journal of the National Cancer Institute 2007 ) "Conclusions: Long-term daily use of adult-strength aspirin may be associated with modestly reduced overall cancer incidence in populations among whom colorectal, prostate, and breast cancers are common."
Adjusted indirect meta-analysis of aspirin plus warfarin at international normalized ratios 2 to 3 versus aspirin plus clopidogrel after acute coronary syndromes. (Am J Cardiol. 2007)
An analysis of mortality rates with dual-antiplatelet therapy in the primary prevention population of the CHARISMA trial. (Eur Heart J. 2007) "Conclusion These findings do not support the use of dual-antiplatelet therapy with clopidogrel and aspirin in a primary prevention population. In this subgroup analysis, CV death occurred more frequently than anticipated."
Aspirin and Decreased Adult-Onset Asthma (American Journal of Respiratory and Critical Care Medicine 2007) "Conclusions: Aspirin reduced the risk of newly diagnosed adult-onset asthma in a large, randomized clinical trial of apparently healthy, aspirin-tolerant men. This result requires replication in randomized trials designed a priori to test this hypothesis; it does not imply that aspirin improves symptoms in patients with asthma."
Aspirin and Reproductive Outcomes. (Obstet Gynecol Surv. 2008)
Aspirin Dose and Duration of Use and Risk of Colorectal Cancer in Men. (Gastroenterology. 2007) "CONCLUSIONS: Regular, long-term aspirin use reduces risk of colorectal cancer among men. However, the benefit of aspirin necessitates at least 6 years of consistent use, with maximal risk reduction at doses greater than 14 tablets per week. The potential hazards associated with long-term use of such doses should be carefully considered."
Aspirin Dose for the Prevention of Cardiovascular Disease (JAMA. 2007) "Conclusions Currently available clinical data do not support the routine, long-term use of aspirin dosages greater than 75 to 81 mg/d in the setting of cardiovascular disease prevention. Higher dosages, which may be commonly prescribed, do not better prevent events but are associated with increased risks of gastrointestinal bleeding."
Aspirin for the Primary Prevention of Cardiovascular Disease in Women (Arch Intern Med 2007) "Conclusions Aspirin use appears to have a favorable cost-utility ratio for older women with moderate cardiovascular risk, but firm conclusions about its effects are limited by the imprecision of available evidence, which comes mainly from 1 trial. Aspirin is indicated for women at higher risk for stroke but should not be prescribed for low-risk women, including most younger women."
Aspirin in Alzheimer's disease (AD2000): a randomised open-label trial (The Lancet Neurology 2008) “Although aspirin is commonly used in dementia, in patients with typical AD 2 years of treatment with low-dose aspirin has no worthwhile benefit and increases the risk of serious bleeds.”
Aspirin resistance and adverse clinical events in patients with coronary artery disease. (Am J Med. 2007) "CONCLUSIONS: Aspirin resistance, defined by an aggregation-based rapid platelet function assay, is associated with an increased risk of adverse clinical outcomes in stable patients with CAD."
Aspirin resistance: does it exist? (Semin Thromb Hemost. 2007)
Clinical use of evidence-based medicine--clinical questions. (WMJ. 2007) "The current evidence does not support using high-dose ASA therapy in patients with known coronary artery disease and a history of gastrointestinal bleeding."
Does enteric-coated aspirin result in a lower incidence of gastrointestinal complications compared to normal aspirin? (Interact Cardiovasc Thorac Surg. 2007)
Does NSAID use modify cognitive trajectories in the elderly? (NEUROLOGY 2007) "Conclusions: Nonsteroidal anti-inflammatory drug use may help to prevent cognitive decline in older adults if started in midlife rather than late life. This effect may be more notable in those who have one or more APOE 4 alleles."
Effect of Aspirin on Lipoprotein(a) in Patients With Ischemic Stroke. (J Stroke Cerebrovasc Dis. 2007) "Results of our study confirm that aspirin lowers the increased Lp(a) levels in patients with ischemic stroke."
Effect of Low-Dose Aspirin on the Occurrence of Venous Thromboembolism (Annals 2007) "Conclusion: These data suggest that long-term, low-dose aspirin treatment has little effect on the prevention of VTE in initially healthy women."
Food-Dependent Exercise-Induced Anaphylaxis Induced by Low Dose Aspirin Therapy. (Allergol Int. 2008) “Discussion: Patients with aspirin-provoked FDEIA have been reported previously as taking ordinary doses of aspirin for reducing pain, inflammation and fever. However, in our patient, low dose aspirin therapy for reducing cardiovascular risk possibility induced FDEIA. Growing numbers of elderly people take low doses of aspirin for prevention of cerebral or myocardial infarction. Therefore, physicians should remember that aspirin consumption, even at low doses, is a risk factor for FDEIA.”
Long-term Aspirin Use and Mortality in Women (Arch Intern Med. 2007) "Conclusions In women, low to moderate doses of aspirin are associated with significantly lower risk of all-cause mortality, particularly in older women and those with cardiac risk factors. A significant benefit is evident within 5 years for cardiovascular disease, whereas a modest benefit for cancer is not apparent until after 10 years of use."
Low-dose aspirin and clopidogrel: how to act in patients scheduled for day surgery. (Curr Opin Anaesthesiol. 2007)
Low-dose aspirin and upper gastrointestinal damage: epidemiology, prevention and treatment. (Curr Med Res Opin. 2007) "CONCLUSIONS: Prophylactic low-dose aspirin therapy is associated with an increased risk of developing upper GI side effects. Administration of a PPI seems the most effective therapy for the prevention and/or relief of such side effects in at-risk patients. H. pylori eradication therapy further reduces the risk of upper GI bleeding in these patients."
Lung cancer and regular use of aspirin and nonaspirin nonsteroidal anti-inflammatory drugs. (Pharmacoepidemiol Drug Saf. 2007) "CONCLUSIONS: The hypothesis that regular use of ASA or NANSAIDs reduces the risk of lung cancer is not supported by the present data."
NSAID use and dementia risk in the Cardiovascular Health Study. Role of APOE and NSAID type. (Neurology. 2007)
NSAIDs for the chemoprevention of Alzheimer's disease. (Subcell Biochem. 2007)
Pathogenesis, diagnosis, and treatment of aspirin intolerance. (Ann Allergy Asthma Immunol. 2007) "RESULTS: The prevalence of AI is approximately 0.3% to 0.9%, but AI is often overlooked. It can display a wide range of clinical pictures, such as acute asthma attacks, urticaria, angioedema, chronic rhinitis, myocardial ischemia, and anaphylactic shock."
Prevention of serious vascular events by aspirin amongst patients with peripheral arterial disease: randomized, double-blind trial (Journal of Internal Medicine 2007) "Conclusions. For the first time direct evidence shows that low-dose aspirin should routinely be considered for PAD patients, including those with concomitant type 2 diabetes."
Review article: hospitalization for gastrointestinal adverse events attributable to the use of low-dose aspirin among patients 50 years or older also using NSAIDS: a retrospective cohort study. (Aliment Pharmacol Ther. 2007)
Salicylate poisoning: an evidence-based consensus guideline for out-of-hospital management. (Clin Toxicol (Phila). 2007)
Silent myocardial ischemia in coronary artery disease patients under aspirin therapy presenting with upper gastrointestinal hemorrhage. (J Gastroenterol Hepatol. 2007) " Conclusion: Myocardial ischemia is a relatively common complication in CAD patients under aspirin therapy presenting with upper gastrointestinal hemorrhage. A history of CAD with triple vessel disease, higher blood urea nitrogen, lower diastolic blood pressure and lower hematocrit may help identify patients who are at increased risk of myocardial ischemia, which tends to be associated with higher in-hospital mortality and increased length of hospital stay."
The discovery of aspirin's antithrombotic effects. (Tex Heart Inst J. 2007) "Aspirin has long been established as a useful analgesic and antipyretic. Even in ancient times, salicylate-containing plants such as the willow were commonly used to relieve pain and fever. In the 20th century, scientists discovered many details of aspirin's anti-inflammatory and analgesic properties, including its molecular mechanism of action. In addition, the latter half of the century brought reports that daily, low doses of aspirin could prevent myocardial infarction and stroke."
The effectiveness of antiplatelet treatment with aspirin in polymorbid patients. (Int Angiol. 2007)
The influence of gender on the effects of aspirin in preventing myocardial infarction. (BMC Med. 2007) "CONCLUSIONS: Gender accounts for a substantial proportion of the variability in the efficacy of aspirin in reducing MI rates across these trials, and supports the notion that women might be less responsive to aspirin than men."
The Role of Aspirin Resistance in the Treatment of Acute Coronary Syndromes. (Clin Cardiol. 2007)
The use of aspirin for primary prevention of colorectal cancer: a systematic review prepared for the u.s. Preventive services task force. (Ann Intern Med. 2007) "CONCLUSIONS: Aspirin appears to be effective at reducing the incidence of colonic adenoma and colorectal cancer, especially if used in high doses for more than 10 years. However, the possible harms of such a practice require careful consideration. Further evaluation of the cost-effectiveness of chemoprevention compared with, and in combination with, a screening strategy is required."
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