SynthesisPloS one2016
Bleeding Risk with Long-Term Low-Dose Aspirin: A Systematic Review of Observational Studies.
Synthesis in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 10 of them syntheses 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
86 citing papers in PubMed, 10 syntheses or guidelines pooled it, 195 citations in OpenAlex.
- Risk of bleeding with concomitant use of oral anticoagulants and aspirin: A systematic review and meta-analysis.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2024Pooled it
- Comparison of gastrointestinal adverse events between fast release tablets and regular acetylsalicylic acid (aspirin) galenics after short-term use: a meta-analysis of randomized clinical trials.Inflammopharmacology · 2023Pooled it
- Statins associate with lower risk of biliary tract cancers: A systematic review and meta-analysis.Cancer medicine · 2023Pooled it
- Effect of low-dose aspirin on health outcomes: An umbrella review of systematic reviews and meta-analyses.British journal of clinical pharmacology · 2020Pooled it
- Aspirin and other non-steroidal anti-inflammatory drugs for the prevention of dementia.The Cochrane database of systematic reviews · 2020Pooled it
- 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2019Guideline
- Pooled it
- The impact of CYP2D6 mediated drug-drug interaction: a systematic review on a combination of metoprolol and paroxetine/fluoxetine.British journal of clinical pharmacology · 2018Pooled it
- Mortality among patients due to adverse drug reactions that lead to hospitalization: a meta-analysis.European journal of clinical pharmacology · 2018Pooled it
- Pooled it
- Eradication ofHealth technology assessment (Winchester, England) · 2025Trial
- Long-Term Effects of Low-Dose Aspirin on Gastrointestinal Symptoms and Bleeding Complications in Patients with Type 2 Diabetes.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025Trial
- Cold Snare Polypectomy in Patients Taking Dual Antiplatelet Therapy: A Randomized Trial of Discontinuation of Thienopyridines.Clinical and translational gastroenterology · 2019Trial
- Triglyceride Polygenic Score Identifies Individuals Who May Respond Differently to Aspirin in Primary Prevention.Clinical pharmacology and therapeutics · 2026Article
- Effects of prophylactic tranexamic acid on bleeding during transbronchial lung biopsy: a double-blind, randomized controlled trial.Annals of medicine and surgery (2012) · 2026Article
- Anti-Thrombotic and Metabolic Protective Effects of Ginseng in High-Fat Diet-Induced Obese Rats: In Vivo Evaluation with In Silico Mechanistic Prediction.Antioxidants (Basel, Switzerland) · 2026Article
- Article
- Can drug-induced platelet dysfunction be reversed?Research and practice in thrombosis and haemostasis · 2026Review
- Managing patients with a history of arterial disease and new venous thromboembolism.Hematology. American Society of Hematology. Education Program · 2025Article
- Outcomes of Oral Anticoagulation with Concomitant NSAID Use: A Registry Based Cohort Study.The American journal of medicine · 2025Article
26 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow-dose aspirin has proven effectiveness in secondary and primary prevention of cardiovascular events, but is also associated with an increased risk of major bleeding events. For primary prevention, this absolute risk must be carefully weighed against the benefits of aspirin; such assessments are currently limited by a lack of data from general populations.
methodsSystematic searches of Medline and Embase were conducted to identify observational studies published between 1946 and 4 March 2015 that reported the risks of gastrointestinal (GI) bleeding or intracranial hemorrhage (ICH) with long-term, low-dose aspirin (75-325 mg/day). Pooled estimates of the relative risk (RR) for bleeding events with aspirin versus non-use were calculated using random-effects models, based on reported estimates of RR (including odds ratios, hazard ratios, incidence rate ratios and standardized incidence ratios) in 39 articles.
findingsThe incidence of GI bleeding with low-dose aspirin was 0.48-3.64 cases per 1000 person-years, and the overall pooled estimate of the RR with low-dose aspirin was 1.4 (95% confidence interval [CI]: 1.2-1.7). For upper and lower GI bleeding, the RRs with low-dose aspirin were 2.3 (2.0-2.6) and 1.8 (1.1-3.0), respectively. Neither aspirin dose nor duration of use had consistent effects on RRs for upper GI bleeding. The estimated RR for ICH with low-dose aspirin was 1.4 (1.2-1.7) overall. Aspirin was associated with increased bleeding risks when combined with non-steroidal anti-inflammatory drugs, clopidogrel and selective serotonin reuptake inhibitors compared with monotherapy. By contrast, concomitant use of proton pump inhibitors decreased upper GI bleeding risks relative to aspirin monotherapy.
conclusionsThe risks of major bleeding with low-dose aspirin in real-world settings are of a similar magnitude to those reported in randomized trials. These data will help inform clinical judgements regarding the use of low-dose aspirin in prevention of cardiovascular events.
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What OpenQuestion holds
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.