SynthesisEuropean journal of epidemiology2015
Prophylactic use of aspirin: systematic review of harms and approaches to mitigation in the general population.
Synthesis in European journal of epidemiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 79 citations in OpenAlex.
- Bleeding Risk with Long-Term Low-Dose Aspirin: A Systematic Review of Observational Studies.PloS one · 2016Pooled it
- Aspirin and the Risk of Colorectal Cancer According to Genetic Susceptibility among Older Individuals.Cancer prevention research (Philadelphia, Pa.) · 2022Trial
- Long-Term Safety of a Coordinated Delivery Tablet of Enteric-Coated Aspirin 325 mg and Immediate-Release Omeprazole 40 mg for Secondary Cardiovascular Disease Prevention in Patients at GI Risk.Cardiovascular therapeutics · 2016Trial
- Life Factors and Melanoma: From the Macroscopic State to the Molecular Mechanism.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Review
- Antithrombotic Therapy Strategies and Clinical Outcomes in Chinese Patients Aged 65 and Older with High Ischemic Risk Coronary Artery Disease.Clinical interventions in aging · 2025Article
- Association of long-term use of low-dose aspirin with Helicobacter pylori infection and effect on recurrence rate.Scientific reports · 2024Article
- Aspirin and cancer treatment: systematic reviews and meta-analyses of evidence: for and against.British journal of cancer · 2024Article
- Colorectal Cancer Chemoprevention: A Dream Coming True?International journal of molecular sciences · 2023Review
- Synergism interaction between genetic polymorphisms in drug metabolizing enzymes and NSAIDs on upper gastrointestinal haemorrhage: a multicenter case-control study.Annals of medicine · 2022Article
- Aspirin and cancer: biological mechanisms and clinical outcomes.Open biology · 2022Review
- Glucosamine use, smoking and risk of incident chronic obstructive pulmonary disease: a large prospective cohort study.The British journal of nutrition · 2022Article
- Assessment of the appropriateness of cardiovascular preventive medication in older people: using the RAND/UCLA Appropriateness Method.BMC geriatrics · 2022Article
- A multicenter case-control study of the effect of e-nos VNTR polymorphism on upper gastrointestinal hemorrhage in NSAID users.Scientific reports · 2021Article
- Public health impact of low-dose aspirin on colorectal cancer, cardiovascular disease and safety in the UK - Results from micro-simulation model.International journal of cardiology. Heart & vasculature · 2021Article
- Aspirin and cancer survival: a systematic review and meta-analyses of 118 observational studies of aspirin and 18 cancers.Ecancermedicalscience · 2021Review
- Effects of aspirin on the gastrointestinal tract: Pros vs. cons.Oncology letters · 2020Review
- Influence of Polymorphisms Involved in Platelet Activation and Inflammatory Response on Aspirin-Related Upper Gastrointestinal Bleeding: A Case-Control Study.Frontiers in pharmacology · 2020Article
- Rapamycin for longevity: opinion article.Aging · 2019Article
- The Value of Helicobacter Eradication in Long-term Aspirin Users.Journal of the National Cancer Institute · 2018Article
- Aspirin: the miracle drug?Clinical and translational gastroenterology · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
A careful assessment of benefits and harms is required to assess suitability of aspirin as a prophylactic public health measure. However, comprehensive population-level data on harms are lacking. We collected and synthesized age and sex-specific data on harms relevant to aspirin use in average-risk individuals aged 50 years or older. We conducted systematic literature searches to identify baseline rates of gastrointestinal (GI) bleeding, peptic ulcer, major extra-cranial bleeding, and case-fatality rates due to GI bleeding or peptic ulcer in general population. The magnitude of aspirin-associated increase, the prevalence and attributable risk of Helicobacter pylori infection on these events in aspirin users was also assessed. Baseline rates of major extracranial bleeding events and GI complications increase with age; an almost threefold to fourfold increase is observed from age 50-54 to 70-74 years. Low or standard-dose aspirin use increases GI bleeding events by 60% leading to an annual excess of 0.45 and 0.79 GI bleeding events per 1,000 women and men aged 50-54 years respectively. 5-10% of major GI complications are fatal; a clear age dependence--higher fatality in older individuals, is seen. Eradication of H. pylori infection before aspirin use could reduce the incidence of upper GI complications by 25-30%. GI complications are increased by about 60% due to aspirin use but are fatal only in a very small proportion of individuals younger than 70 years of age. Major bleeding events that are comparable in severity to cancer or CVD, are infrequent. Screening and eradication of H. pylori infection could substantially lower aspirin-related GI harms.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.