| Review article: gastrointestinal bleeding with low-dose aspirin - what's the risk? | |
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MedLine Citation:
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PMID: 16948802 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This review examines ulcers and gastrointestinal bleeding with low-dose aspirin, focusing on randomized placebo-controlled trials. The single endoscopic trial assessing ulcers showed no significant difference in 12-week ulcer incidence: 6% of 381 given placebo vs. 7% of 387 given 81 mg enteric-coated aspirin. The relative risk of major gastrointestinal bleeding with low-dose aspirin in a meta-analysis of placebo-controlled trials of vascular protection was 2.07 (95% CI: 1.61-2.66). The absolute rate increase with aspirin above placebo was 0.12% per year (95% CI: 0.07-0.19%) with a number-needed-to-harm of 833 patients (95% CI: 526-1429). A meta-analysis of aspirin 50-1500 mg daily reported an odds ratio for any gastrointestinal bleeding of 1.68 (95% CI: 1.51-1.88) with an number-needed-to-harm at 1 year of 247. The relative risk of hospitalization for upper gastrointestinal bleeding with low-dose aspirin in a large Danish cohort study was 2.6 (95% CI: 2.2-2.9) with an absolute annual incidence of 0.6%. Factors that may increase the risk of gastrointestinal bleeding include prior history of ulcers or gastrointestinal bleeding, corticosteroid use, anticoagulant therapy and addition of a non-aspirin non-steroidal anti-inflammatory drug. When determining whether low-dose aspirin is appropriate for an individual patient, the cardiovascular benefit must be weighed against the potential for clinical events such as gastrointestinal bleeding. |
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Authors:
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L Laine |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Alimentary pharmacology & therapeutics Volume: 24 ISSN: 0269-2813 ISO Abbreviation: Aliment. Pharmacol. Ther. Publication Date: 2006 Sep |
Date Detail:
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Created Date: 2006-09-04 Completed Date: 2007-03-29 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8707234 Medline TA: Aliment Pharmacol Ther Country: England |
Other Details:
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Languages: eng Pagination: 897-908 Citation Subset: IM |
Affiliation:
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Department of Medicine, U.S.C. School of Medicine, Los Angeles, CA 90033, USA. llaine@usc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Cortex Hormones
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adverse effects Aging / physiology Anti-Inflammatory Agents, Non-Steroidal / adverse effects Anticoagulants / adverse effects Aspirin / administration & dosage, adverse effects* Cardiovascular Diseases / prevention & control Cyclooxygenase 2 Inhibitors / adverse effects Drug Administration Schedule Gastrointestinal Diseases / chemically induced* Gastrointestinal Hemorrhage / chemically induced Humans Randomized Controlled Trials as Topic Risk Factors Ulcer / chemically induced Warfarin / adverse effects |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Anticoagulants; 0/Cyclooxygenase 2 Inhibitors; 50-78-2/Aspirin; 81-81-2/Warfarin |
| Comments/Corrections | |
Comment In:
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Aliment Pharmacol Ther. 2007 Feb 1;25(3):345-6; author reply 346-7
[PMID:
17217449
]
ACP J Club. 2007 Jan-Feb;146(1):13 [PMID: 17203933 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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