aspirin (Ecotrin, Empirin, Bayer aspirin, Vazalore, ASA)
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Introduction
Acetylsalicylic acid (ASA). Enteric-coated acetylsalicylic acid (ECASA). Tradenames: Ecotrin, Empirin, Bayer.
Indications
- temporary relief of minor aches & pains, inflammation & fever
- prophylaxis for myocardial infarction, ischemic stroke
- secondary prevention of cardiovascular disease
- secondary stroke prevention (relative risk reduction of 13%)
- low-dose aspirin reduces risk of all-cause dementia in adults with coronary artery disease[98]
- USPSTF recommends aspirin for primary prevention for:
- prevention of cardiovascular disease in adults age 50-59 years of age with a 10-year cardiovascular risk of >= 10%[99]
- USPSTF reccommends against low-dose aspirin for primary prevention in adults >= 60 years[99]
- other recommendations for primary prevention
- prevention of colorectal cancer in adults 50-69 years of age[67][69]
- no benefit in primary prevention of fatal myocardial infarction[41]
- aspirin 100 mg QD reduces risk of serious vascular events (RR=0.88) but increases risk of major bleeding (RR=1.3) in patients with diabetes mellitus[78]
- no benefit for primary prevention in patients with or without diabetes mellitus[57]
- FDA recommends against use of aspirin for primary prevention[58]
- reduction in cardiovascular risk at cost of increased risk for major bleed[85]
- inconclusive evidence on whether discontinuation of aspirin for primary prevention after at age 70 years is associated with benefit or harm[102]
- individualized benefit-harm analysis may be appropriate[90]
- may only be effective in patients with systolic blood pressure < 130 mm Hg[6]
- 75-150 mg QD as effective as higher doses[9] 75-162 mg recommended by American Heart Association[16]
- no benefit of added dipyridamole[9]
- 10% less effective than clopidogrel or ticlopidine[9]
- stopping aspirin may result in increased risk of heart attack & stroke (increased platelet production)[19]
- 81 mg QD may not reduce atherosclerotic events in adults with type 2 diabetes[24]
- no better than placebo in patients with peripheral arterial disease[29][37]
- no benefit in primary prevention for Japanese men > 60 years of age[60]
- low-dose aspirin does not prevent primary cardiovascular events in black patients[92]
- 100 mg QD of no benefit for primary prevention in non-diabetic men >= 55 years + 2-4 risk factors or women >= 60 years + >= 3 risk factors (increased risk of GI bleed noted)[79]
- no benefit for primary prevention of cardiovascular disease or mortality (100 mg/day) in healthy elderly[80]
- aspirin use >= 3 times per week reduces cardiovascular mortality in elderly (RR=0.7)[91]
- secondary prevention of cardiovascular disease
- treatment of acute MI
- percutaneous coronary intervention (used with clopidogrel)
- management of rheumatoid arthritis, rheumatic fever, osteoarthritis, bursitis
- Kawasaki disease:
- combined with warfarin (INR of 3) for high-risk patients with artificial heart valves
- prophylaxis for venous thromboembolism:
- may diminish risks of cancer, death from cancer, & cancer metastasis[42][44]
- may diminish risk of colon cancer[9]
- benefit of colorectal cancer prevention is not apparent until 10 years after aspirin therapy is started[69][112]
- see aspirin & colorectal polyps & Nurses Health Study
- does not reduce mortality from colon cancer[28]
- USPSTF says evidence inconclusive to recommend for or against aspirin for prevention of colorectal cancer[99]
- dose-independent reduction in mortality due to proximal colon cancer & rectal cancer
- no reduction in mortality due to distal colon cancer[38]
- aspirin lowers risk of colorectal cancer in patients with wild-tyep BRAF but not mutated BRAF[54]
- aspirin 100 mg QOD reduces risk of colorectal cancer (RR = 0.80) in middle-aged women
- does not reduce total cancer risk or all-cause mortality[55]
- may diminish risk of gastrointestinal cancer (RR=0.85) when used at least twice weekly for > 6 years[68]
- reduces risk of colorectal cancer, esophageal cancer, & gastric cancer[59]*
- associated with lower cancer mortality, especially for gastrointestinal cancers, regardless of weight[93]
- may reduce risk of prostate cancer[9]
- may reduce risk of ovarian cancer[9][82]
- may reduce risk of breast cancer[12]
- may reduce mortality in patients with breast cancer[36]
- may reduce mortality from several adenocarcinomas[39]
- may reduce risk of hepatocellular carcinoma (RR = 0.59)[48][82]
- may reduce risk of melanoma in postmenopausal white women[52]
- modestly reduces risk of lung cancer, breast cancer, & prostate cancer[59]
- low-dose aspirin < 100 mg/day at least twice a week lowers risk for lung cancer 11% after 9 years[87]
- aspirin use >= 3 times per week reduces cancer mortality in elderly (RR=0.9)[91]
- may diminish risk of colon cancer[9]
- reduces risk of death from chronic liver disease (RR = 0.55)[48]
* risk for nontrivial bleeding roughly equals benefit in primary prevention of nonfatal myocardial infarction[41]
* benefit exceeds bleeding risk for myocardial infarction, ischemic stroke, & cancer[59]
Contraindications
- USPSTF recommends against initiating aspirin for primary prevention of cardiovascular disease (CVD) in adults >= 60 years[99]
- modeling data suggests risk of continuing low-dose aspirin for primary prevention beyond age 75 may exceed benefit.
- no benefit initiating aspirin for primary prevention of CVD in patients with chronic kidney disease CKD3 or CKD4[115]
- does NOT block restenosis after coronary angioplasty or carotid endarterectomy
- of NO benefit in primary stroke prevention for men
- see sex differences for aspirin therapy
- old-age alone not indication for low-dose aspirin[17]
- no benefit for low-dose (81 mg) ASA in preventing cancer or cardiovascular disease in women[18]
- no benefit for low-dose (81 mg) ASA in preventing cognitive impairment in middle-age & elderly subjects at moderate cardiovascular risk[23]
- no evidence that low-dose aspirin (< 300 mg/day prevents cognitive decline or dementia or improves cognitive test scores[72][95]
- of no benefit in prevention of depression in the elderly[94]
- routine use of low-dose aspirin for primary prevention of cardiovascular disease in apparently healthy individuals, including those with elevated blood pressure, diabetes or low ankle-brachial index (< 0.95)[33][36]
- for most patients risks outweigh benefits for primary prevention[88]
- in older adults (> 70 years) 100 mg of aspirin daily may accelerate progression of cancer[96]
- of no cardiovascular benefit in patients on hemodialysis[103]
- low-dose aspirin does not decrease risk of falls in the elderly, but increases risk of serious falls[104]
- low-dose aspirin result in a 38% increase in intracranial bleeding among healthy older adult without any reduced risk of ischemic stroke[107]
Caution:
- aspirin may cause severe asthma
- clopidogrel if aspirin would be indicated but patient intolerant
- a triad of asthma, nasal polyposis & aspirin sensitivity
- control hypertension before starting aspirin[21]
- uncertain net value; reduction in cardiovascular events needs to be weighed against risk of major bleed[30]
Benefit/risk
- number needed to treat (NNT) (primary prevention)[62]
- 1667 for 1 year to prevent 1 cardiovascular event
- 146 for patients already taking aspirin for primary prevention[75]
- 2000 for 1 year to prevent 1 non-fatal MI
- 3000 for 1 year to preccent 1 non-fatal stroke
- no mortality benefit[62]
- number needed to harm*
- 3300 for 1 year to precipitate 1 major bleeding event
- 1667 for 1 year to prevent 1 cardiovascular event
- number needed to treat (NNT) (secondary prevention)[63]
- 50 for 2 years to prevent 1 cardiovascular event
- 36 for 1 year to prevent 1 cardiovascular event in patient already taking aspirin for secondary prevention[75]
- 333 for 2 years to prevent 1 death
- 77 for 2 years to prevent 1 non-fatal MI
- 200 for 2 years to prevent 1 stroke
- number needed to harm*
- 400 for 2 years to induce 1 major hemorrhage[63]
- 50 for 2 years to prevent 1 cardiovascular event
- number needed to treat immediately following STEMI[64]
- 42 to save 1 life
- 167 to result in non-dangerous bleeding
- number needed to treat with 160-600 mg QD within 48 hours following ischemic stroke[65]
- 79 for mortality, dependency
- 143 to prevent recurrent stroke
- number needed to harm
- 245 for major hemorrhage
- 574 for intracranial hemorrhage[65]
* likely comparing different doses of aspirin or perhaps different patient population with different comorbidities
Dosage
- prevention of stroke, heart attack:
- 75-81 mg PO QD sufficient[45][97]
- no difference in safety or efficacy for secondary prevention of cardiovascular events of 81 mg vs 325 mg QD (male or female)[111]
- lifetime therapy for secondary prevention[40]
- add proton pump inhibitor to aspirin for elderly[73]
- headache, myalgia, arthralgia: 325-650 mg every 4 hours or 325-975 mg every 6 hours
Tabs: 81, 325, 500, 650, 975 mg.
Suppository: 120, 200, 300, 600 mg.
Enteric-coated as effective as plain aspirin in prevention of cardiovascular disease[11]; may be less effective[49]; effectiveness & safety in patients with cardiovascular disease similar[109]
Quick-release form: 325 mg, 500 mg (Bayer)
Vazalore with a special complex within the capsule allows for targeted release of aspirin minimizing direct contact with the stomach.[101]
- Capsules 81 mg, 325 mg
Pharmacokinetics
- hydrolyzes to salicylate by esterases in the GI mucosa, erythrocytes, synovial fluid & blood
- salicylate is metabolized by the liver
- 1/2 life of parent compound is 15-20 minutes
- 1/2 life of salicylate is 3-10 hours
- onset of analgesia is 30 minutes
- duration of action is 3-4 hours
elimination via kidney
1/2life = 0.25-0.33 hours
Adverse effects
- nausea/vomiting
- dyspepsia/heartburn*
- risk of GI bleeding
- risk of GI bleeding increases with age (with or without aspirin)
- older age & male sex are important risk factors for GI bleeding (USPSTF)[112][113][114]
- increased risk for major hemorrhage (RR = 1.55)
- RR = 1.55 for low dose aspirin[43]
- increased risk for GI bleed when used for primary prevention (100 mg/day) in healthy elderly[80]
- elderly > 75 years at highest risk 31/100,000[110]
- bleeding risk correlates with ischemic risk[61]
- no increase in risk for patients with diabetes mellitus
- risk of serious GI bleeding is 2 times greater in men than in women[112][113][114]
- gastrointestinal ulceration (0.06%/year 75-500 mg daily)*
- low dose in combination with proton pump inhibitor
- risk of cardiovascular complications after stopping low dose aspirin outweighs risk of GI bleed in patients who take aspirin for secondary prophylaxis[34]
- clopidogrel alone is more likely to cause recurrent GI bleeding than aspirin combined with a PPI[34]
- lower GI bleed
- continued use of low-dose asprin after lower GI bleed associated with increased risk of bleeding (19% vs 7% for placebo at 5 years) but lower overall mortality (23% vs. 36%) in apparently high-risk patients[70]
- intracranial hemorrhage
- increases risk of hemorrhagic stroke[7][8] (0.02%/year), especially with hypertension[21]
- doses > 200 mg/day double the risk of bleeding[12]
- does NOT increase risk of intracranial hemorrhage with head trauma in the elderly[13]
- low dose aspirin 75-300 mg QD does not increase risk of intracranial hemorrhage[76]
- iron-deficiency anemia uncommon with low-dose aspirin[106]
- risk vs benefit calculator[53]
- RR = 1.55 for low dose aspirin[43]
- rash
- dyspnea
- bronchospasm
- renal impairment (may contribute to anemia)
- exacerbation of gout
- low-dose aspirin (<= 325 mg/day) blocks uric acid secretion & increases serum uric acic[5][56]
- treatment with hypouricemic agent may lower risk[56]
- high-dose aspirin in uricosuric[56]
- aspirin primarily affects cochlear function of the inner ear
- tinnitus, hearing loss
- little or no vertigo[108]
- allergic reactions (anaphylactoid reactions)
- urticaria
- angioedema
- results from inhibition of cyclooxygenase
- no skin testing is available
- antigen desensitization if NSAIDs are imperitive
- leukotriene & 5-lipoxygenase inhibitors attenuate allergic reaction to aspirin
- may be associated with nasal polyps & rhinosinusitis
- increased risk of neovascular type late macular degeneration (RR = 1.7)[50][51]
- data not strong enough to overturn use of aspirin for evidence-based indications[51]
- heart failure?
- 325 mg QD does not appear to worsen heart failure (all patients taking ACE inhibitor)[74]
- risk of heart failure for patients taking daily aspirin for 5 years (RR-1.26)[100]
- proton pump inhibitors should be considered for patients on long-term antiplatelet therapy if:[3]
- history of peptic ulcer or gastrointestinal bleeding
- dual antiplatelet therapy or con6co6mitan6t anticoagulation
- additional risk factors (age >6=6 60, steroid use, dyspepsia, or gastroesophageal reflux)
- in patients with a history of ulcer histories who are starting chronic antiplatelet therapy, test for & eradicate H pylori[3]
- famotidine 20 mg BID prevents peptic ulcers & erosive esophagitis in patients taking low-dose aspirin[32]
Toxicity: (management)
- overdose
- induce emesis with ipecac
- gastric lavage with saline
- follow with activated charcoal
- dehydration
- IV fluids (normal or 1/2 normal saline) with KCl
- do NOT use D5W
- metabolic acidosis - sodium bicarbonate
- hyperthermia - spone baths, fan, cooling blanket
- coagulopathy/hemorrhage - IV vitamin K
- hypoglycemia (with coma, seizures, or mental status change)
- seizures: diazepam 5-10 mg IV
- drug adverse effects of NSAIDs
- drug adverse effects of antiplatelet agents
- drug adverse effects of antithrombotic agent(s)
Drug interactions
- corticosteroids increases risk of GI & renal-related toxicity
- aspirin may antagonize uricosuric effect of probenecid
- aspirin increases methotrexate levels by binding site displacement & inhibiting renal excretion
- increased risk of bleeding when coadministered with warfarin
- may displace valproic acid from binding sites & increase toxicity
- ibuprofen & other NSAIDs may inhibit antiplatelet activity of aspirin[10]
- aspirin does not significantly increase blood pressure when used in combination with antihypertensives[71]
- aspirin might inhibit action of ACE inhibitors[74]
- dichlorphenamide increases aspirin levels (contraindicated)
- drug interaction(s) of direct oral anticoagulants (DOAC) with NSAIDs
- drug interaction(s) of anti-platelet agents with SSRIs
- drug interaction(s) of aspirin with proton pump inhibitors
- drug interaction(s) of antiplatelet agents with proton pump inhibitors
- drug interaction(s) of cholinesterase inhibitors with NSAIDs
- drug interaction(s) of lithium carbonate with NSAIDs
- drug interaction(s) of beta-adrenergic receptor antagonists with salicylate
- drug interaction(s) of salicylates with sulfonylureas
- drug interaction(s) of NSAIDs with oral contraceptive
- drug interaction(s) of NSAIDs with SSRIs
- drug interaction(s) of NSAIDs with antidepressants
- drug interaction(s) of aspirin with NSAIDs
- drug interaction(s) of apixaban with NSAIDs
- drug interaction(s) of warfarin with NSAIDs
- drug interaction(s) of warfarin with antiplatelet agents
- drug interaction(s) of NSAIDs with beta blockers
- drug interaction(s) of NSAIDs with ARBs
- drug interaction(s) of NSAIDs with aldosterone antagonis
- drug interaction(s) of NSAIDs with glucocorticoid
- drug interaction(s) of NSAIDs, diuretics & angiotensin II receptor antagonists
- drug interaction(s) of NSAIDs, diuretics & ACE inhibitors
- drug interaction(s) of NSAIDs with ACE inhibitors
- drug interaction(s) of NSAIDs & antihypertensives
- drug interaction(s) of NSAIDs & loop diuretics
- drug interaction(s) of NSAIDs & aspirin
- drug interaction(s) of aspirin, P2Y12 inhibitors & anticoagulants
Mechanism of action
- inhibits prostaglandin synthesis
- cyclo-oxygenase 1
- GI effects
- renal effects
- inhibition of platelet aggregation
- cyclo-oxygenase 2
- anti-inflammatory properties
- cyclo-oxygenase 1
- acts on temperature regulation center in the hypothalamus
- inhibits formation of thromboxane A2
- irreversibile platelet effects last 10 days
- inhibits NF-kappa B in macrophages
- diabetes mellitus does not affect platelet function or response to low-dose aspirin[84]
Notes
- risk vs benefit calculator[53]
More general terms
Additional terms
Component of
- aspirin/citrate/diphenhydramine
- aspirin/bromadiolone/citrate/sodium bicarbonate
- acetaminophen/aspirin/citrate/diphenhydramine
- acetaminophen/aspirin/caffeine/diphenhydramine
- acetaminophen/aspirin/caffeine/citrate/diphenhydramine
- aspirin/phenyltoloxamine
- aspirin/dextromethorphan/phenylephrine
- aspirin/dextromethorphan/doxylamine/phenylephrine
- aspirin/codeine/phosphate
- aspirin/citrate/diphenhydramine/nov protein
- aspirin/camphor/menthol/methyl salicylate
- acetaminophen/aspirin/pseudoephedrine
- acetaminophen/aspirin/codeine
- acetaminophen/aspirin/caffeine/codeine/salicylamide
- aspirin/caffeine/dihydrocodeine
- aspirin/calcium carbonate
- aspirin/hydrocodone
- aspirin/diphenhydramine
- aspirin/chlorpheniramine/phenylephrine
- aspirin/caffeine/citrate/orphenadrine
- aspirin/caffeine
- aspirin/meprobamate
- aspirin/caffeine/salicylamide
- aspirin/citrate/sodium bicarbonate
- acetaminophen/aspirin/diphenhydramine
- acetaminophen/aspirin
- acetaminophen/aspirin/caffeine/salicylamide
- aspirin/citric acid/sodium bicarbonate (Alka-Seltzer)
- aspirin/HMG CoA reductase inhibitor
- NO aspirin (NCX-4016, nitric oxide releasing)
- aspirin/pravastatin (Pravigard PAC)
- aspirin/caffeine/propoxyphene (Darvon Compound)
- aspirin/codeine (Empirin with Codeine)
- aspirin/butalbital/caffeine/codeine (Fiorinal with Codeine)
- aspirin/oxycodone (Percodan)
- acetaminophen/aspirin/caffeine (Excedrin Extra, Excedrin migraine)
- aspirin/carisoprodol (Soma Compound)
- aspirin/carisoprodol/codeine (Soma Compound with Codeine)
- aspirin/pentazocine (Talwin Compound)
- aluminum hydroxide/aspirin/magnesium hydroxide (Ascriptin)
- aspirin/butalbital/caffeine (Fiorinal)
- aspirin/caffeine/orphenadrine (Norgesic)
- aspirin/methocarbamol (Robaxisal)
- aspirin/dipyridamole (Aggrenox)
- polypill (Polycap)
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 14
- ↑ 3.0 3.1 3.2 Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 5.0 5.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 17, 18. American College of Physicians, Philadelphia 1998, 2006, 2015, 2018.
- ↑ 6.0 6.1 Prescriber's Letter 7(8):47 2000
- ↑ 7.0 7.1 Prescriber's Letter 9(2):7 2002
- ↑ 8.0 8.1 Journal Watch 22(4):33, 2002 USPTF 3 2002 guidelines
- ↑ 9.0 9.1 9.2 9.3 9.4 9.5 9.6 Prescriber's Letter 9(5):29 2002 Journal Watch 23(8):62, 2003
- ↑ 10.0 10.1 Prescriber's Letter 10(3):15 2003
- ↑ 11.0 11.1 Prescriber's Letter 10(4):21 2003
- ↑ 12.0 12.1 12.2 Prescriber's Letter 10(11):63 2003
- ↑ 13.0 13.1 Journal Watch 23(23):183-84, 2003 Spektor S et al, J Neurosurg 99:661, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14567600
- ↑ Journal Watch 24(13):101, 2004 Terry MB, Gammon MD, Zhang FF, Tawfik H, Teitelbaum SL, Britton JA, Subbaramaiah K, Dannenberg AJ, Neugut AI. Association of frequency and duration of aspirin use and hormone receptor status with breast cancer risk. JAMA. 2004 May 26;291(20):2433-40. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15161893
- ↑ 15.0 15.1 Prescriber's Letter 12(3): 2005 Safety of Clopidogrel (Plavix) in Patients at Risk for Ulcers Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210304&pb=PRL (subscription needed) http://www.prescribersletter.com
Journal Watch 25(4):29, 2005 Chan FK, Ching JY, Hung LC, Wong VW, Leung VK, Kung NN, Hui AJ, Wu JC, Leung WK, Lee VW, Lee KK, Lee YT, Lau JY, To KF, Chan HL, Chung SC, Sung JJ. Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding. N Engl J Med. 2005 Jan 20;352(3):238-44. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15659723
Cryer B. Reducing the risks of gastrointestinal bleeding with antiplatelet therapies. N Engl J Med. 2005 Jan 20;352(3):287-9. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15659730 - ↑ 16.0 16.1 Prescriber's Letter 12(4): 2005 Primary Prevention of Cardiovascular Disease in Women Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210409&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 17.0 17.1 Journal Watch 25(15):118, 2005 Nelson MR, Liew D, Bertram M, Vos T. Epidemiological modelling of routine use of low dose aspirin for the primary prevention of coronary heart disease and stroke in those aged > or =70. BMJ. 2005 Jun 4;330(7503):1306. Epub 2005 May 20. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15908442 <Internet> http://bmj.bmjjournals.com/cgi/content/full/330/7503/1306
- ↑ 18.0 18.1 Cook NR, Lee IM, Gaziano JM, Gordon D, Ridker PM, Manson JE, Hennekens CH, Buring JE. Low-dose aspirin in the primary prevention of cancer: the Women's Health Study: a randomized controlled trial. JAMA. 2005 Jul 6;294(1):47-55. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15998890
- ↑ 19.0 19.1 Prescriber's Letter 12(9): 2005 The Risks of Stopping Low-Dose Aspirin Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=211011&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 20.0 20.1 Targownik LE & Al-Mamfud A The prevalence of risk factors for gastrointestinal complications and use of gastroprotection among persons hospitalized for cardiovascular disease. Aliment Pharmacol Ther 2006; 23:743 Using Aspirin in Hypertensive Patients PMID: https://www.ncbi.nlm.nih.gov/pubmed/16556176
- ↑ 21.0 21.1 21.2 Prescriber's Letter 14(10): 2007 Using Aspirin in Hypertensive Patients Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=231003&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Prescriber's Letter 15(8): 2008 Can Aspirin 162 mg a Day Keep The Doctor Away? Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=240808&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 23.0 23.1 Price JF et al. Low dose aspirin and cognitive function in middle aged to elderly adults: Randomised controlled trial. BMJ 2008 Sep 1; 337:a1198. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/18762476 (<Internet> http://dx.doi.org/10.1136/bmj.a1198)
- ↑ 24.0 24.1 Ogawa H et al, Low-Dose Aspirin for Primary Prevention of Atherosclerotic Events in Patients With Type 2 Diabetes JAMA. 2008;300(18) <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/18997198 <Internet> http://jama.ama-assn.org/cgi/content/full/2008.623
- ↑ 25.0 25.1 Prescriber's Letter 15(21): 2008 Reducing the Risk for GI Bleeding with Antiplatelet Drugs Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=241205&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Bhatt DL et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. Am J Gastroenterol 2008 Nov; 103:2890.
Bhatt DL et al, ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2008 Oct 28;52(18):1502-17. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19017521
Bhatt DL et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: A report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation 2008 Oct 28; 118:1894. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18836135 - ↑ U.S. Preventive Services Task Force Aspirin for the Prevention of Cardiovascular Disease: U.S. Preventive Services Task Force Recommendation Statement Ann Intern Med. 2009 Mar 17;150(6):396-404. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19293072
corresponding NGC Guideline withdrawn Dec 2014
Wolff T, Miller T, Ko S. Aspirin for the primary prevention of cardiovascular events: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2009 Mar 17;150(6):405-10. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19293073 - ↑ 28.0 28.1 Cole BF et al Aspirin for the chemoprevention of colorectal adenomas: Meta-analysis of the randomized trials. J Natl Cancer Inst 2009 Feb 18; 101:256. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19211452
Grau MV et al. Nonsteroidal anti-inflammatory drug use after 3 years of aspirin use and colorectal adenoma risk: Observational follow-up of a randomized study. J Natl Cancer Inst 2009 Feb 18; 101:267. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19211442 - ↑ 29.0 29.1 Berger JS et al Aspirin for the prevention of cardiovascular events in patients with peripheral artery disease: A meta-analysis of randomized trials. JAMA 2009 May 13; 301:1909. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19436018
Dermott MM and Criqui MH. Aspirin and secondary prevention in peripheral artery disease: A perspective for the early 21st century. JAMA 2009 May 13; 301:1927. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19436022 - ↑ 30.0 30.1 Antithrombotic Trialists' (ATT) Collaboration Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials The Lancet, Volume 373, Issue 9678, Pages 1849 - 1860, 30 May 2009 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60503-1/fulltext
- ↑ Prescriber's Letter 16(6): 2009 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=250601&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 32.0 32.1 Taha AS Famotidine for the prevention of peptic ulcers and oesophagitis in patients taking low-dose aspirin (FAMOUS): a phase III, randomised, double-blind, placebo-controlled trial. Lancet, Volume 374, Issue 9684, Pages 119-125, 11 July 2009 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19577798
- ↑ 33.0 33.1 U.S. Preventive Services Task Force recommendation statement. Aspirin for the Prevention of Cardiovascular Disease http://www.ahrq.gov/clinic/USpstf/uspsasmi.htm http://www.uspreventiveservicestaskforce.org/uspstf/uspsasmi.htm
- ↑ 34.0 34.1 34.2 Sung JJY et al Continuation of low-dose aspirin in peptic ulcer bleeding: A randomized trial. Ann Intern Med. 2010 Jan 5;152(1):1-9. Epub 2009 Nov 30. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19949136 <Internet> http://www.annals.org/content/early/2009/11/19/0003-4819-152-1-201001050-00179.full?aimhp
Prescriber's Letter 17(3): 2010 COMMENTARY: Using Low-Dose Aspirin After a GI Bleed PATIENT HANDOUT: Aspirin and Your Heart PATIENT HANDOUT SPANISH VERSION: La Aspirina y el Corazon GUIDELINES: Recommendations on the Management of Patients with Nonvariceal Upper Gastrointestinal Bleeding Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260313&pb=PRL (subscription needed) http://www.prescribersletter.com - ↑ Prescriber's Letter 17(2): 2010 Aspirin for Primary Prevention Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260201&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 36.0 36.1 36.2 Holmes MD et al. Aspirin intake and survival after breast cancer. J Clin Oncol 2010 Feb 16; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20159825 <Internet> http://dx.doi.org/10.1200/JCO.2009.22.7918
- ↑ 37.0 37.1 Fowkes FGR et al Aspirin for prevention of cardiovascular events in a general population screened for a low ankle brachial index: A randomized controlled trial. JAMA 2010 Mar 3; 303:841. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20197530
Berger JS. Aspirin as preventive therapy in patients with asymptomatic vascular disease. JAMA 2010 Mar 3; 303:880. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20197537 - ↑ 38.0 38.1 Rothwell PM et al. Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Lancet 2010 Nov 20; 376:1741 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20970847
- ↑ 39.0 39.1 Rothwell PM et al Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials Lancet. 2011 Jan 1;377(9759):31-41. Epub 2010 Dec 6. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21144578 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62110-1/abstract
- ↑ 40.0 40.1 Garcia Rodriguez LA et al Discontinuation of low dose aspirin and risk of myocardial infarction: case-control study in UK primary care BMJ 2011; 343:d4094 http://www.bmj.com/content/343/bmj.d4094.full
- ↑ 41.0 41.1 41.2 Seshasai SRK et al. Effect of aspirin on vascular and nonvascular outcomes: Meta-analysis of randomized controlled trials. Arch Intern Med 2012 Feb 13; 172:209 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22231610
Mora S. Aspirin therapy in primary prevention: To use or not to use? Arch Intern Med 2012 Feb 13; 172:217. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22231608 - ↑ 42.0 42.1 Rothwell PM et al Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. The Lancet, Early Online Publication, 21 March 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22440946 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61720-0/abstract
Rothwell PM et al Effect of daily aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trials. The Lancet, Early Online Publication, 21 March 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22440947 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60209-8/abstract
Algra AM and Rothwell PM Effects of regular aspirin on long-term cancer incidence and metastasis: a systematic comparison of evidence from observational studies versus randomised trials The Lancet Oncology, Early Online Publication, 21 March 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22440112 <Internet> http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(12)70112-2/abstract
Chan AT and Cook NR Are we ready to recommend aspirin for cancer prevention? The Lancet, Early Online Publication, 21 March 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22440945 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61654-1/fulltext - ↑ 43.0 43.1 De Berardis G, Lucisano G et al Association of Aspirin Use With Major Bleeding in Patients With and Without Diabetes JAMA. 2012;307(21):2286-2294 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22706834 <Internet> http://jama.jamanetwork.com/article.aspx?articleID=1172042
Siller-Matula JM Hemorrhagic Complications Associated With Aspirin: An Underestimated Hazard in Clinical Practice? JAMA. 2012;307(21):2318-2320 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22706838 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1172021 - ↑ 44.0 44.1 Jacobs EJ et al Daily Aspirin Use and Cancer Mortality in a Large US Cohort JNCI J Natl Cancer Inst (2012), August 10 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22888140 <Internet> http://jnci.oxfordjournals.org/content/early/2012/08/10/jnci.djs318.abstract
Baron JA Aspirin and Cancer: Trials and Observational Studies JNCI J Natl Cancer Inst (2012), August 10 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22888142 <Internet> http://jnci.oxfordjournals.org/content/early/2012/08/10/jnci.djs338.full - ↑ 45.0 45.1 Prescriber's Letter 19(9): 2012 Aspirin Dose for Cardiovascular Indications Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=280919&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Prescriber's Letter 19(11): 2012 COMMENTARY: The Truth About Aspirin CHART: Aspirin Dose for Cardiovascular Indications PATIENT EDUCATION HANDOUT: Aspirin and Your Heart Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=281105&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 47.0 47.1 Becattini C et al. Aspirin for preventing the recurrence of venous thromboembolism. N Engl J Med 2012 May 24; 366:1959 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22621626
Brighton TA et al. Low-dose aspirin for preventing recurrent venous thromboembolism. N Engl J Med 2012 Nov 4; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23121403 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1210384 - ↑ 48.0 48.1 48.2 Sahasrabuddhe VV et al Nonsteroidal Anti-inflammatory Drug Use, Chronic Liver Disease, and Hepatocellular Carcinoma JNCI J Natl Cancer Inst (2012) November 28 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/3197492 <Internet> http://jnci.oxfordjournals.org/content/early/2012/11/28/jnci.djs452.abstract
Levy IG and Pim CP An Aspirin a Day: The Allure (and Distraction) of Chemoprevention JNCI J Natl Cancer Inst (2012) November 28 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23197493 <Internet> http://jnci.oxfordjournals.org/content/early/2012/11/28/jnci.djs462.full - ↑ 49.0 49.1 Grosser T et al Drug Resistance and Pseudoresistance: An Unintended Consequence of Enteric Coating Aspirin. Circulation. December 4, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23212718 <Internet> http://circ.ahajournals.org/content/early/2012/12/04/CIRCULATIONAHA.112.117283.abstract
- ↑ 50.0 50.1 Klein BEK et al Long-term Use of Aspirin and Age-Related Macular Degeneration JAMA. 2012;308(23):2469-2478 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23288416 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1486830
Prescriber's Letter 20(3): 2013 Does Aspirin Increase the Risk of Macular Degeneration? Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=290306&pb=PRL (subscription needed) http://www.prescribersletter.com - ↑ 51.0 51.1 51.2 Liew G et al. The association of aspirin use with age-related macular degeneration. JAMA Intern Med 2013 Feb 25; 173:258. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23337937
Kaul S and Diamond GA. Relationship of aspirin use with age-related macular degeneration: Association or causation? JAMA Intern Med 2013 Feb 25; 173:264 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23338290 - ↑ 52.0 52.1 Gamba CA et al Aspirin is associated with lower melanoma risk among postmenopausal Caucasian women. The Women's Health Initiative. Cancer 2013 Mar 11 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23483536 <Internet> http://onlinelibrary.wiley.com/doi/10.1002/cncr.27817/abstract
- ↑ 53.0 53.1 53.2 Lanas A et al. The aspirin cardiovascular/gastrointestinal risk calculator
a tool to aid clinicians in practice. Aliment Pharmacol Ther 2013 Apr; 37:738. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23413984
The CV/GI risk Calculator for ASA users http://azormultimedia.es/calculadora/ - ↑ 54.0 54.1 Nishihara R et al. Aspirin use and risk of colorectal cancer according to BRAF mutation status. JAMA 2013 Jun 26; 309:2563 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23800934
- ↑ 55.0 55.1 Physician's First Watch, Julu 16, 2013 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org https://annals.org/article.aspx?articleid=1709803 https://annals.org/article.aspx?articleid=1709806
- ↑ 56.0 56.1 56.2 56.3 Zhang Y et al. Low-dose aspirin use and recurrent gout attacks. Ann Rheum Dis 2014 Feb; 73:385 PMID:23345599 http://ard.bmj.com/content/73/2/385
- ↑ 57.0 57.1 Matthys F1, De Backer T, De Backer G, Stichele RV. Review of guidelines on primary prevention of cardiovascular disease with aspirin: how much evidence is needed to turn a tanker? Eur J Prev Cardiol. 2014 Mar;21(3):354-65 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23610452
Moreno G1, Mangione CM. Management of cardiovascular disease risk factors in older adults with type 2 diabetes mellitus: 2002-2012 literature review. J Am Geriatr Soc. 2013 Nov;61(11):2027-37 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24219205 - ↑ 58.0 58.1 Husten L FDA Comes Out Against Aspirin for Primary Prevention Physician's First Watch, May 6, 2014 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
FDA.Information for Consumers. May 2, 2014. Use of Aspirin for Primary Prevention of Heart Attack and Stroke. http://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm390574.htm - ↑ 59.0 59.1 59.2 59.3 Cusick J et al Estimates of benefits and harms of prophylactic use of aspirin in the general population. Annals of Oncology, August 4, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25096604 <Internet> http://annonc.oxfordjournals.org/content/early/2014/07/30/annonc.mdu225.full
- ↑ 60.0 60.1 Ikeda Y et al. Low-dose aspirin for primary prevention of cardiovascular events in Japanese patients 60 years or older with atherosclerotic risk factors: A randomized clinical trial. JAMA 2014 Nov 17 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25401325 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1936801
- ↑ 61.0 61.1 Husten L, Hefner JE High Rate of Inappropriate Use of Aspirin for Primary Prevention. Physician's First Watch, Jan 13, 2015 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Hira RS et al Frequency and Practice-Level Variation in Inappropriate Aspirin Use for the Primary Prevention of Cardiovascular Disease. J Am Coll Cardiol. 2015;65(2):111-121 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25593051 <Internet> http://content.onlinejacc.org/article.aspx?articleID=2089094
Verheugt FWA The Role of the Cardiologist in the Primary Prevention of Cardiovascular Disease With Aspirin. J Am Coll Cardiol. 2015;65(2):122-124 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25593052 <Internet> http://content.onlinejacc.org/article.aspx?articleID=2089095 - ↑ 62.0 62.1 62.2 The NNT: Aspirin to Prevent a First Heart Attack or Stroke. http://www.thennt.com/nnt/aspirin-to-prevent-a-first-heart-attack-or-stroke/
- ↑ 63.0 63.1 63.2 The NNT: Aspirin to Prevent Cardiovascular Disease in Patients with Known Heart Disease or Strokes. http://www.thennt.com/nnt/aspirin-for-cardiovascular-prevention-after-prior-heart-attack-or-stroke/
- ↑ 64.0 64.1 The NNT: Aspirin Given Immediately for a Major Heart Attack (STEMI) http://www.thennt.com/nnt/aspirin-for-major-heart-attack/
- ↑ 65.0 65.1 65.2 The NNT: Antiplatelet Agents for Acute Ischemic Stroke. http://www.thennt.com/nnt/antiplatelet-agents-for-acute-stroke/
Sandercock PA, Counsell C, Gubitz GJ, Tseng MC. Antiplatelet therapy for acute ischaemic stroke. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD000029 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18646056 - ↑ Hennekens CH, Dalen JE. Aspirin in the treatment and prevention of cardiovascular disease: past and current perspectives and future directions. Am J Med. 2013 May;126(5):373-8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23499330
- ↑ 67.0 67.1 67.2 US Preventive Services Task Force (USPSTF) Draft Recommendation Statement Aspirin to Prevent Cardiovascular Disease and Cancer http://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement/aspirin-to-prevent-cardiovascular-disease-and-cancer
- ↑ 68.0 68.1 Cao Y, Nishihara R, Wu K et al Population-wide Impact of Long-term Use of Aspirin and the Risk for Cancer. JAMA Oncol. Published online March 03, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26940135 <Internet> http://oncology.jamanetwork.com/article.aspx?articleid=2497878
Vilar E, Maresso KC, Hawk ET. Aspirin for Cancer Prevention. One Step Closer. JAMA Oncol. Published online March 03, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26939883 <Internet> http://oncology.jamanetwork.com/article.aspx?articleid=2497876 - ↑ 69.0 69.1 69.2 69.3 Bibbins-Domingo K on behalf of the U.S. Preventive Services Task Force. Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. Published online 12 April 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27064677 <Internet> http://annals.org/article.aspx?articleid=2513179
Guirguis-Blake JM, Evans CV, Senger CA, O'Connor EA, Whitlock EP. Aspirin for the Primary Prevention of Cardiovascular Events: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Ann Intern Med. 2016 Jun 21;164(12):804-13. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27064410 Free article. Review. - ↑ 70.0 70.1 Chan FK et al. Risks of bleeding recurrence in cardiovascular events with continued aspirin use after lower gastrointestinal hemorrhage. Gastroenterology 2016 Apr 26; PMID: https://www.ncbi.nlm.nih.gov/pubmed/27130815
- ↑ 71.0 71.1 Paauw DS Dangerous and Deadly Drug Combinations Medscape. June 30, 2016 http://www.medscape.com/features/slideshow/dangerous-drug-combination
- ↑ 72.0 72.1 Veronese N, Stubbs B, Maggi S et al Low-Dose Aspirin Use and Cognitive Function in Older Age: A Systematic Review and Meta-analysis. J Am Geriatr Soc. 2017 Apr 20. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28425093
- ↑ 73.0 73.1 Li L, Geraghty OC, Mehta Z et al Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events: a population-based cohort study. Lancet. Jun 13, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26227434 Free full text <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30770-5/fulltext
Diener HC Preventing major gastrointestinal bleeding in elderly patients. Lancet. Jun 13, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28622952 Free Article <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31507-6/fulltext - ↑ 74.0 74.1 74.2 Teerlink JR, Qian M, Bello NA et al. Aspirin does not increase heart failure events in heart failure patients: From the WARCEF trial. JACC Heart Fail 2017 Aug; 5:603. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28774396
- ↑ 75.0 75.1 75.2 Sundstrom J, Hedberg J, Thuresson M et al Low-Dose Aspirin Discontinuation and Risk of Cardiovascular Events. A Swedish Nationwide, Population-Based Cohort Study. Circulation. 2017;136:1183-1192 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28947478 <Internet> http://circ.ahajournals.org/content/136/13/1183
- ↑ 76.0 76.1 Cea Soriano L et al. Low-dose aspirin and risk of intracranial bleeds: An observational study in UK general practice. Neurology 2017 Nov 28; 89:2280 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29093065 <Internet> http://n.neurology.org/content/89/22/2280
- ↑ 77.0 77.1 Rothwell PM, Cook NR, Gaziano JM et al Effects of aspirin on risks of vascular events and cancer according to bodyweight and dose: analysis of individual patient data from randomised trials. Lancet. July 12, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30017552 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31133-4/fulltext
Theken KN, Grosser T Weight-adjusted aspirin for cardiovascular prevention. Lancet. July 12, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30017553 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31307-2/fulltext - ↑ 78.0 78.1 The ASCEND Study Collaborative Group. Effects of aspirin for primary prevention in persons with diabetes mellitus. N Engl J Med 2018 Aug 26; PMID: https://www.ncbi.nlm.nih.gov/pubmed/30146931 Free Article https://www.nejm.org/doi/10.1056/NEJMoa1804988
- ↑ 79.0 79.1 Gaziano JM, Brotons C, Coppolecchia R et al. Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): A randomised, double-blind, placebo-controlled trial. Lancet 2018 Aug 24 pii: S0140-6736(18)31924-X. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30158069 https://www.jwatch.org/na47429/2018/08/28/aspirin-was-not-beneficial-primary-prevention-trial
- ↑ 80.0 80.1 80.2 McNeil JJ, Woods RL, Nelson MR et al Effect of Aspirin on Disability-free Survival in the Healthy Elderly. N Engl J Med. Sept 16, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30221596 https://www.nejm.org/doi/full/10.1056/NEJMoa1800722
McNeil JJ, Wolf R, Woods RL et al Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. N Engl J Med. Sept 16, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30221597 https://www.nejm.org/doi/full/10.1056/NEJMoa1805819
McNeil JJ, Nelson MR, Woods RL et al Effect of Aspirin on All-Cause Mortality in the Healthy Elderly. N Engl J Med. Sept 16, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30221595 https://www.nejm.org/doi/full/10.1056/NEJMoa1803955 - ↑ 81.0 81.1 White AA, Stevenson DD Aspirin-Exacerbated Respiratory Disease. N Engl J Med 2018; 379:1060-1070 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30207919 https://www.nejm.org/doi/full/10.1056/NEJMra1712125
- ↑ 82.0 82.1 82.2 Simon TG, Ma Y, Ludvigsson JF et al Association Between Aspirin Use and Risk of Hepatocellular Carcinoma. JAMA Oncol. Published online October 4, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30286235 https://jamanetwork.com/journals/jamaoncology/fullarticle/2704212
Barnard ME, Poole EM, Curhan GC et al Association of Analgesic Use With Risk of Ovarian Cancer in the Nurses' Health Study. JAMA Oncol. Published online October 4, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30286239 https://jamanetwork.com/journals/jamaoncology/fullarticle/2704211
Seewaldt VL. Aspirin and Chemoprevention - Have We Arrived? JAMA Oncol. Published online October 4, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30286216 https://jamanetwork.com/journals/jamaoncology/fullarticle/2704207 - ↑ Ridker PM Should Aspirin Be Used for Primary Prevention in the Post-Statin Era? N Engl J Med 2018; 379:1572-1574. Oct 18 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30332575 https://www.nejm.org/doi/full/10.1056/NEJMe1812000
- ↑ 84.0 84.1 Al-Sofiani ME, Yanek LR, Faraday N et al. Diabetes and platelet response to low-dose aspirin. J Clin Endocrinol Metab 2018 Dec; 103:4599. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30265320
- ↑ 85.0 85.1 Zheng SL, Roddick AJ Association of Aspirin Use for Primary Prevention With Cardiovascular Events and Bleeding Events. A Systematic Review and Meta-analysis. JAMA. 2019;321(3):277-287. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30667501 ree full text https://jamanetwork.com/journals/jama/fullarticle/2721178
Gaziano JM Aspirin for Primary PreventionClinical Considerations in 2019. JAMA. 2019;321(3):253-255 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30667488 https://jamanetwork.com/journals/jama/fullarticle/2721162 - ↑ Selak V, Jackson R, Poppe K et al. Predicting bleeding risk to guide aspirin use for the primary prevention of cardiovascular disease: A cohort study. Ann Intern Med 2019 Feb 26; PMID: https://www.ncbi.nlm.nih.gov/pubmed/30802900 https://annals.org/aim/article-abstract/2726667/predicting-bleeding-risk-guide-aspirin-use-primary-prevention-cardiovascular-disease
- ↑ 87.0 87.1 Ye S, Lee M, Lee D et al. Association of long-term use of low-dose aspirin as chemoprevention with risk of lung cancer. JAMA Netw Open 2019 Mar 1; 2:e190185 Not indexed in PubMed https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2726712
- ↑ 88.0 88.1 Abdelaziz HK, Saad M, Pothineni NVK et al. Aspirin for primary prevention of cardiovascular events. J Am Coll Cardiol 2019 Jun 18; 73:2915. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31196447 https://www.sciencedirect.com/science/article/pii/S0735109719348582
Pignone M. What is so hard about aspirin for primary prevention? PMID: https://www.ncbi.nlm.nih.gov/pubmed/31196448 J Am Coll Cardiol 2019 Jun 18; 73:2930. https://www.sciencedirect.com/science/article/pii/S0735109719348594 - ↑ 89.0 89.1 Moayyedi P, Eikelboom JW, Bosch J et al. Pantoprazole to prevent gastroduodenal events in patients receiving rivaroxaban and/or aspirin in a randomized, double-blind, placebo-controlled trial. Gastroenterology 2019 Aug; 157:403 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31054846 https://www.gastrojournal.org/article/S0016-5085(19)36764-2/fulltext
- ↑ 90.0 90.1 Selak V, Jackson R, Poppe K Personalized Prediction of Cardiovascular Benefits and Bleeding Harms From Aspirin for Primary Prevention: A Benefit-Harm Analysis. Ann Intern Med. 2019. Swpt 17. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31525775 https://annals.org/aim/article-abstract/2751452/personalized-prediction-cardiovascular-benefits-bleeding-harms-from-aspirin-primary-prevention
Kostis JB Individualize Treatment With Aspirin for Primary Prevention. Ann Intern Med. 2019. Swpt 17. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31525772 https://annals.org/aim/article-abstract/2751685/individualize-treatment-aspirin-primary-prevention - ↑ 91.0 91.1 91.2 Loomans-Kropp HA, Pinsky P, Cao Y, Chan AT, Umar A. Association of Aspirin Use With Mortality Risk Among Older Adult Participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. JAMA Netw Open. 2019;2(12):e1916729. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31800071 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2756258
- ↑ 92.0 92.1 Fernandez-Jimenez R, Wang TJ, Fuster V, Blot WJ Low-Dose Aspirin for Primary Prevention of Cardiovascular Disease: Use Patterns and Impact Across Race and Ethnicity in the Southern Community Cohort Study. J Am Heart Assoc. Dec 11, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31822218 Free full text https://www.ahajournals.org/doi/10.1161/JAHA.119.013404
- ↑ 93.0 93.1 Loomans-Kropp HA et al. Association of aspirin use with mortality risk among older adult participants in the prostate, lung, colorectal, and ovarian cancer screening trial. JAMA Netw Open 2019 Dec 4; 2:e1916729. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31800071 Free PMC Article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2756258
- ↑ 94.0 94.1 Berk M, Woods RL, Nelson MR et al. Effect of aspirin vs placebo on the prevention of depression in older people: A randomized clinical trial. JAMA Psychiatry 2020 Jun 3;:e201214. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32492080 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2766709
- ↑ 95.0 95.1 Ryan J, Storey E, Murray AM et al. Randomized placebo-controlled trial of the effects of aspirin on dementia and cognitive decline. Neurology 2020 Jul 21; 95:e320. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32213642 https://n.neurology.org/content/95/3/e320
- ↑ 96.0 96.1 McNeil JJ et al. Effect of aspirin on cancer incidence and mortality in older adults. J Natl Cancer Inst 2021 Mar 1; 113:258 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32778876 Free PMC article. https://academic.oup.com/jnci/article/113/3/258/5889955
- ↑ 97.0 97.1 Jones WS, Mulder H, Wruck LM et al. Comparative effectiveness of aspirin dosing in cardiovascular disease. N Engl J Med 2021 May 15; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33999548 https://www.nejm.org/doi/10.1056/NEJMoa2102137
- ↑ 98.0 98.1 Kling J Low-Dose Aspirin Linked to Lower Dementia Risk in Some Individuals Medscape - Aug 03, 2021. https://www.medscape.com/viewarticle/955944
- ↑ 99.0 99.1 99.2 99.3 99.4 Hughes S USPSTF Rules Out Aspirin for Over 60s in Primary CVD Prevention Medscape. October 12, 2021 https://www.medscape.com/viewarticle/960745
US Preventive Services Task Force Aspirin Use to Prevent Cardiovascular Disease: Preventive Medication Draft Recommendation Statement. October 12, 2021 https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/aspirin-use-to-prevent-cardiovascular-disease-preventive-medication#bootstrap-panel--6
US Preventive Services Task Force Aspirin Use to Prevent Cardiovascular Disease. US Preventive Services Task Force Recommendation Statement. JAMA. 2022;327(16):1577-1584. April 26. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35471505 https://jamanetwork.com/journals/jama/fullarticle/2791399
Guirguis-Blake JM et al. Aspirin use to prevent cardiovascular disease and colorectal cancer: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 2022 Apr 26; 327:1585-1597 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35471507 https://jamanetwork.com/journals/jama/fullarticle/2791401
Brett AS Should Patients Take Aspirin for Primary Cardiovascular Prevention? Updated Recommendations From the US Preventive Services Task Force. JAMA. 2022;327(16):1552-1554 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35471530 https://jamanetwork.com/journals/jama/fullarticle/2791432
Otto MA USPSTF: The Jury Is Out on Aspirin for CRC Prevention. Medscape. April 27, 2022 https://www.medscape.com/viewarticle/972794 - ↑ 100.0 100.1 Bosworth T Daily Aspirin Linked to Increased Risk of Heart Failure. Medscape. November 24, 2021 https://www.medscape.com/viewarticle/963641
Mujaj B, Zhang ZY, Yang WY ey al Aspirin use is associated with increased risk for incident heart failure: a patient-level pooled analysis. ESC Heart Failure. 2021, Nov 22 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34808706 Free article https://onlinelibrary.wiley.com/doi/10.1002/ehf2.13688 - ↑ 101.0 101.1 https://www.vazalore.com/
- ↑ 102.0 102.1 Nelson MR et al. Safety of ceasing aspirin used without a clinical indication after age 70 years: A subgroup analysis of the ASPREE randomized trial. Ann Intern Med 2022 Mar 15; [e-pub] https://www.acpjournals.org/doi/10.7326/M21-3823
- ↑ 103.0 103.1 Ethier J et al Aspirin prescription and outcomes in hemodialysis patients: the Dialysis Outcomes and Practice Patterns Study (DOPPS)/ Am J Kidney Dis. 2007 Oct;50(4):602-11. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17900460
- ↑ 104.0 104.1 Kneisel K Daily Aspirin No Help for Fracture Prevention in Seniors, Raises Risk of Falls. Serious falls 17% more frequent in low-dose aspirin arm, ASPREE substudy finds. MedPage Today November 7, 2022 https://www.medpagetoday.com/geriatrics/generalgeriatrics/101629
Barker AL, Morello R, Thao LTP et al Daily Low-Dose Aspirin and Risk of Serious Falls and Fractures in Healthy Older People. A Substudy of the ASPREE Randomized Clinical Trial. JAMA Intern Med. Published online November 7, 2022 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36342703 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2797772 - ↑ 105.0 105.1 Windle ML Rapid Rx Quiz: Headache Medications Medscape. Sept 12, 2022 https://reference.medscape.com/viewarticle/980181
- ↑ 106.0 106.1 McQuilten ZK et al. Effect of low-dose aspirin versus placebo on incidence of anemia in the elderly: A secondary analysis of the Aspirin in Reducing Events in the Elderly trial. Ann Intern Med 2023 Jun 20; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37335992 https://www.acpjournals.org/doi/10.7326/M23-0675
- ↑ 107.0 107.1 Cloud GC, Williamson JD, Thao LTP et al Low-Dose Aspirin and the Risk of Stroke and Intracerebral Bleeding in Healthy Older People. Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2023;6(7):e2325803 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37494038 Free article. Clinical Trial. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807630
- ↑ 108.0 108.1 NEJM Knowledge+ Question ot the Week. August 15, 2023 https://knowledgeplus.nejm.org/question-of-week/1380/
- ↑ 109.0 109.1 Sleem A et al. Effectiveness and safety of enteric-coated vs uncoated aspirin in patients with cardiovascular disease: A secondary analysis of the ADAPTABLE randomized clinical trial. JAMA Cardiol 2023 Nov; 8:1061. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37792369 PMCID: PMC10551818 Free PMC article https://jamanetwork.com/journals/jamacardiology/fullarticle/2809795
- ↑ 110.0 110.1 Li DK, Laine L, Shung DL. Trends in Upper Gastrointestinal Bleeding in Patients on Primary Prevention Aspirin: A Nationwide Emergency Department Sample Analysis, 2016-2020. Am J Med. 2023 Dec;136(12):1179-1186.e1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37696350
- ↑ 111.0 111.1 Benziger CP, Stebbins A, Wruck LM et al Aspirin Dosing for Secondary Prevention of Atherosclerotic Cardiovascular Disease in Male and Female Patients. A Secondary Analysis of the ADAPTABLE Randomized Clinical Trial. JAMA Cardiol. Published online July 10, 2024 https://jamanetwork.com/journals/jamacardiology/fullarticle/2820444
- ↑ 112.0 112.1 112.2 112.3 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
- ↑ 113.0 113.1 113.2 Whitlock EP, Burda BU, Williams SB, Guirguis-Blake JM, Evans CV. Bleeding Risks With Aspirin Use for Primary Prevention in Adults: A Systematic Review for the U.S. Preventive Services Task Force. Ann Intern Med. 2016 Jun 21;164(12):826-35. doi:http://dx.doi.org/ 10.7326/M15-2112. Epub 2016 Apr 12. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27064261 Free article. Review.
- ↑ 114.0 114.1 114.2 Chubak J, Whitlock EP, Williams SB et al Aspirin for the Prevention of Cancer Incidence and Mortality: Systematic Evidence Reviews for the U.S. Preventive Services Task Force. Ann Intern Med. 2016 Jun 21;164(12):814-25. doi:http://dx.doi.org/ 10.7326/M15-2117. Epub 2016 Apr 12. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27064482 Free article. Review.
- ↑ 115.0 115.1 Kim JY, Lim H, Park CH et al Use of Aspirin and Initial Cardiovascular and Bleeding Risk in Patients with Chronic Kidney Disease. Clinical Journal of the American Society of Nephrology. 2024. Nov 14. Not yet indexed in PubMed https://journals.lww.com/cjasn/abstract/9900/use_of_aspirin_and_initial_cardiovascular_and.499.aspx