Trial reportGut2021
Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial.
Trial report in Gut, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01038583 (Aspirin in Reducing Events in the Elderly), which is not on this map. Cited by 62 papers, 5 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.
Aspirin in Reducing Events in the Elderly
Who cites it
62 citing papers in PubMed, 5 syntheses or guidelines pooled it, 130 citations in OpenAlex.
- Proton pump inhibitors for prevention of upper and lower gastrointestinal bleeding in patients taking aspirin: a systematic review and meta-analysis.European journal of clinical pharmacology · 2026Pooled it
- Efficacy of Jianpi formulas in reducing the recurrence of colorectal adenoma after polypectomy: a systematic review and Meta-analysis.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2025Pooled it
- Efficacy and safety of different traditional Chinese medicine injections in the treatment of unstable angina pectoris: a systematic review and Bayesian network meta-analysis.Frontiers in pharmacology · 2025Pooled it
- Effects of Chinese herbal medicine on colorectal adenoma recurrence following polypectomy: a systematic review and meta-analysis.Frontiers in pharmacology · 2025Pooled it
- Pooled it
- Functional disability after clinically significant extracranial bleeding: a secondary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) Trial.Journal of thrombosis and haemostasis : JTH · 2025Trial
- Daily low-dose aspirin and incident type 2 diabetes in community-dwelling healthy older adults: a post-hoc analysis of efficacy and safety in the ASPREE randomised placebo-controlled trial.The lancet. Diabetes & endocrinology · 2024Trial
- Impact of antithrombotic therapy on management and prognosis of patients hospitalized for upper gastrointestinal bleeding: a multicenter retrospective cohort study.Internal and emergency medicine · 2026Article
- Management of Peptic Ulcer Disease in Patients Taking Antithrombotic Agents.The Korean journal of helicobacter and upper gastrointestinal research · 2026Review
- Platelet-neutrophil cooperation in cancer: mechanisms of metastatic niche formation and implications for prognostic stratification and therapy.Cellular oncology (Dordrecht, Netherlands) · 2026Review
- Association between Type 2 Diabetes and Gastrointestinal Bleeding: A Nationwide Population-Based Cohort Study in South Korea.Gut and liver · 2026Article
- [Cardiovascular diseases and heart failure in diabetes: diagnostics and management (Update 2026)].Wiener klinische Wochenschrift · 2026Review
- Aspirin Dosing in Secondary Prevention of Atherosclerotic Cardiovascular Disease.Current cardiology reports · 2026Review
- Article
- Fufanglongxujie Capsules Protect against Aspirin-induced Gastric Mucosal Lesions in Rats with Myocardial Ischemia-reperfusion Injury.Current pharmaceutical biotechnology · 2026Article
- Development and External Validation of a Nomogram for Predicting Upper Gastrointestinal Bleeding in Patients After Percutaneous Coronary Intervention: A Retrospective Multicenter Cohort Study.International journal of general medicine · 2026Article
- Integrating Network Pharmacology and Metabolomics to Elucidate the Mechanism of Cryptotanshinone Against Platelet Aggregation.Current issues in molecular biology · 2025Article
- Association of cardiometabolic risk burden with gastrointestinal bleeding in aspirin users.BMC gastroenterology · 2025Article
- Gastro-Esophageal Disorders of the Geriatric Population.The American journal of gastroenterology · 2025Article
- Review
2 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
14 authors at 8 institutions in 2 countries.
Funding
Abstract
objectiveThere is a lack of robust data on significant gastrointestinal bleeding in older people using aspirin. We calculated the incidence, risk factors and absolute risk using data from a large randomised, controlled trial.
designData were extracted from an aspirin versus placebo primary prevention trial conducted throughout 2010-2017 ('ASPirin in Reducing Events in the Elderly (ASPREE)', n=19 114) in community-dwelling persons aged ≥70 years. Clinical characteristics were collected at baseline and annually. The endpoint was major GI bleeding that resulted in transfusion, hospitalisation, surgery or death, adjudicated independently by two physicians blinded to trial arm.
resultsOver a median follow-up of 4.7 years (88 389 person years), there were 137 upper GI bleeds (89 in aspirin arm and 48 in placebo arm, HR 1.87, 95% CI 1.32 to 2.66, p<0.01) and 127 lower GI bleeds (73 in aspirin and 54 in placebo arm, HR 1.36, 95% CI 0.96 to 1.94, p=0.08) reflecting a 60% increase in bleeding overall. There were two fatal bleeds in the placebo arm. Multivariable analyses indicated age, smoking, hypertension, chronic kidney disease and obesity increased bleeding risk. The absolute 5-year risk of bleeding was 0.25% (95% CI 0.16% to 0.37%) for a 70 year old not on aspirin and up to 5.03% (2.56% to 8.73%) for an 80 year old taking aspirin with additional risk factors.
conclusionAspirin increases overall GI bleeding risk by 60%; however, the 5-year absolute risk of serious bleeding is modest in younger, well individuals. These data may assist patients and their clinicians to make informed decisions about prophylactic use of aspirin. TRIAL REGISTRATION NUMBER: ASPREE. NCT01038583.
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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.