AIMS: Because of the widespread use of aspirin for prevention of cardiovascular diseases, side-effects associated with thromboprophylactic doses are of interest. This study summarizes the relative risk (RR) for serious upper gastrointestinal complications (UGIC) associated with aspirin exposure in general and with specific aspirin doses and formulations in particular. METHODS: After a systematic review, 17 original epidemiologic studies published between 1990 and 2001 were selected according to predefined criteria. Heterogeneity of effects was explored. Pooled estimates were calculated according to different study characteristics and patterns of aspirin use. RESULTS: The overall relative risk of UGIC associated with aspirin use was 2.2 (95% confidence interval (CI): 2.1, 2.4) for cohort studies and nested case-control studies and 3.1 (95% CI: 2.8, 3.3) for non-nested case-control studies. Original studies found a dose-response relationship between UGIC and aspirin, although the risk was still elevated for doses lower or up to 300 mg day(-1). The summary RR was 2.6 (95% CI: 2.3, 2.9) for plain, 5.3 (95% CI: 3.0, 9.2) for buffered, and 2.4 (95% CI: 1.9, 2.9) for enteric-coated aspirin formulations. CONCLUSIONS: Aspirin was associated with UGIC even when used at low doses or in buffered or enteric-coated formulations. The latter findings may be partially explained by channeling of susceptible patients to these formulations.
AIMS: Because of the widespread use of aspirin for prevention of cardiovascular diseases, side-effects associated with thromboprophylactic doses are of interest. This study summarizes the relative risk (RR) for serious upper gastrointestinal complications (UGIC) associated with aspirin exposure in general and with specific aspirin doses and formulations in particular. METHODS: After a systematic review, 17 original epidemiologic studies published between 1990 and 2001 were selected according to predefined criteria. Heterogeneity of effects was explored. Pooled estimates were calculated according to different study characteristics and patterns of aspirin use. RESULTS: The overall relative risk of UGIC associated with aspirin use was 2.2 (95% confidence interval (CI): 2.1, 2.4) for cohort studies and nested case-control studies and 3.1 (95% CI: 2.8, 3.3) for non-nested case-control studies. Original studies found a dose-response relationship between UGIC and aspirin, although the risk was still elevated for doses lower or up to 300 mg day(-1). The summary RR was 2.6 (95% CI: 2.3, 2.9) for plain, 5.3 (95% CI: 3.0, 9.2) for buffered, and 2.4 (95% CI: 1.9, 2.9) for enteric-coated aspirin formulations. CONCLUSIONS:Aspirin was associated with UGIC even when used at low doses or in buffered or enteric-coated formulations. The latter findings may be partially explained by channeling of susceptible patients to these formulations.
Authors: D W Kaufman; J P Kelly; B E Wiholm; A Laszlo; J E Sheehan; R S Koff; S Shapiro Journal: Am J Gastroenterol Date: 1999-11 Impact factor: 10.864
Authors: J Weil; M J Langman; P Wainwright; D H Lawson; M Rawlins; R F Logan; T P Brown; M P Vessey; M Murphy; D G Colin-Jones Journal: Gut Date: 2000-01 Impact factor: 23.059
Authors: Teddy Kosoglou; Larisa Reyderman; Renger G Tiessen; André A van Vliet; Robert R Fales; Robert Keller; Bo Yang; David L Cutler Journal: Eur J Clin Pharmacol Date: 2011-09-21 Impact factor: 2.953
Authors: L Kristin Newby; Manjushri V Bhapkar; Harvey D White; David J Moliterno; Nancy M Allen LaPointe; David E Kandzari; Freek W A Verheugt; Judith M Kramer; Paul W Armstrong; Robert M Califf Journal: J Thromb Thrombolysis Date: 2003-12 Impact factor: 2.300
Authors: Richard H Hunt; Denis Choquette; Brian N Craig; Carlo De Angelis; Flavio Habal; Gordon Fulthorpe; John I Stewart; Alexander G G Turpie; Paul Davis Journal: Can Fam Physician Date: 2007-07 Impact factor: 3.275
Authors: David H Adler; Joy D Cogan; John A Phillips; Nathalie Schnetz-Boutaud; Ginger L Milne; Tina Iverson; Jeffrey A Stein; David A Brenner; Jason D Morrow; Olivier Boutaud; John A Oates Journal: J Clin Invest Date: 2008-06 Impact factor: 14.808