| |
| The scientific references below deal primarily with the context of stroke and Aspirin (Acetylsalicylic Acid) therapy. They include international* clinical studies with large numbers of patients, in addition some reviews on this issue and some pharmacological** studies. Excerpts and/or conclusions of these studies (this are not external or added comments) which appeared significant are indicated in red. However, these excerpts serve for general information only and do not purport to contain all relevant information. In order to make an own evaluation it is recommended to read the whole articles. The references shall, in addition, assist to assess Aspirin studies or comments from other sources that disclose other conclusions in this context.
(*indicates primary nationality of study group, **indicates a pharmacological study; Abbr. cv = cardiovascular)
|
| REFERENCES |
Curr Atheroscler Rep 2007 9(5) 409: Aspirin in the treatment and prevention of cardiovascular disease: current perspectives and future directions *USA
In primary prevention, Aspirin data on stroke and cardiovascular disease death remain inconclusive |
Ann Intern Med 2007 147(8) 525: Effect of low-dose Aspirin on the occurrence of venous thromboembolism. A randomized trial *USA
Editors Note: Aspirin is ineffective prophylaxis for venous thromboembolism women with few or no risk factors |
Am J Kidney Dis. 2007 50(4) 602: Aspirin prescription and outcomes in hemodialysis patients: the Dialysis Outcomes and Practice Patterns Study (DOPPS) *CANADA
Hypothesis that prescribing Aspirin to hemodialysis patients decreases cardiovascular disease risk is not supported. |
JAMA. 2007 297(18) 2018: Aspirin dose for the prevention of cardiovascular disease: a systematic review *USA
Currently available clinical data do not support the routine, long-term use of Aspirin dosages greater than 75 to 81 mg/d in the setting of cardiovascular disease prevention. |
Am J Cardiol 2006 98(6) 746: Meta-analysis of data from the six primary prevention trials of cardiovascular events using aspirin *USA
In primary prevention of cv events the role of Aspirin has not been established firmly. Sample consists of 47,293 subjects on Aspirin and 45,580 not on Aspirin or placebo. No significant differences in the incidences of stroke or cv mortality |
Stroke 2006 37(1) 129: Regular aspirin-use preceding the onset of primary intracerebral hemorrhage is an independent predictor for death *FINLAND
Regular Aspirin-use preceding the onset of intracerebral hemorrhage associated significantly with hematoma enlargement during the first week and increased mortality. Probably attributable to rapid enlargement of hematomas, in the subjects with intracerebral hemorrhage who had been taking regularly moderate doses of aspirin (250 mg) immediately before the onset of the stroke. |
Neurology 2005 65(7) 1000: Antiplatelet therapy contributes to acute deterioration of intracerebral hemorrhage *JAPAN
Antiplatelet therapy seems to contribute to the acute clinical deterioration of intracerebral hemorrhage |
BMJ 2005 330(7504) 1366: Risk of myocardial infarction in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case-control analysis *UNITED KINGDOM
Enough concerns may exist to warrant reconsideration of cardioavascular safety of all NSAIDs. |
N Engl J Med 2005 352(13) 1293: A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women *USA
A non significant finding with respect to the primary end point. |
DMW 2005 130(49) 2847: Primary prevention of cardiovascular diseases with acetylsalicylic acid *GERMANY
Therapy with Aspirin showed no reduction in terms of overall mortality rate or rate of cardiovascular death. In view of the absence of life prolonging effect and no possibility of determining a definite risk group, that would have a special or accessory effect from a primary prevention with Aspirin, there is no indication for such a scheme. |
J Intern Med 2003 254(6) 584: Aspirin in the prevention of progressing stroke: a randomized controlled study *SWEDEN
No positive effect of Aspirin of the expected size could be shown on the frequency of stroke progression or patient outcome. |
Neuroepidemiology 2001 20(1) 40: Aspirin use and risk of stroke in the elderly: the Rotterdam Study *THE NETHERLANDS
In the total study population there was a non significant association between Aspirin use and the risk of stroke. Stratification by history of vascular diseases revealed that Aspirin considerably increased the risk of first-ever stroke in subjects free from vascular disease |
Neurol Res 2001 23(7) 745: The effect of vasodilators on aspirin-induced antagonism of t-PA thrombolysis *USA
Aspirin therapy reduced regional cerebral blood flow |
Arch Neurol 2000 57(3) 326: Aspirin for the primary prevention of stroke and other major vascular events: meta-analysis and hypotheses *USA
Intracranial hemorrhage was increased by the regular use of Aspirin similarly for both primary and secondary prevention. In 4 large observational studies, self-selected use of Aspirin was consistently associated with higher rates of stroke. Possible small increase for healthy persons due to accentuated intracranial hemorrhage. |
Am Heart J 1999 138(4Pt1) 663: Comparison of the efficacy and safety of aspirin alone with coumadin plus aspirin after provisional coronary stenting: final and follow-up results of a randomized study *GERMANY
Aspirin alone at the low dose of 100 mg administered after high-pressure coronary stenting does not prevent adverse clinical events |
Stroke 1999 30(9) 1764: Prospective study of aspirin use and risk of stroke in women *USA
Women who use 15 or more aspirin per week have an increased risk of subarachnoid hemorrhage. This observational study suggests hazards for hemorrhagic stroke with high frequency of use. The effect on total stroke will depend on the dose of Aspirin and the distribution of stroke subtypes and risk factors in the population. |
Neurol Res 1999 21(5) 488: Aspirin reduces experimental cerebral blood flow in vivo *USA **PHARMACOL
High dose aspirin acutely reduced cerebral blood flow by approximately 20% in a rabbit model. This result may help explain the possible increase in ischemic stroke seen in low risk patients on Aspirin therapy |
JAMA 1998 280(22) 1930: Aspirin and risk of hemorrhagic stroke: a meta-analysis of randomized controlled trials *USA.
Results indicate that Aspirin therapy increases the risk of hemorrhagic stroke |
Stroke 1998 29(5) 887: Aspirin use and incident stroke in the cardiovascular health study. CHS Collaborative Research Group *USA
Randomized clinical trials testing aspirin in relatively low-risk, middle-aged people have consistently shown small increases in stroke associated with Aspirin use. Frequent Aspirin use was associated with an increased rate of ischemic stroke compared with nonusers (P=0.001). After adjustment for other stroke risk factors, women who used aspirin frequently or infrequently at study entry had a 1.8-fold increased risk of ischemic stroke, respectively compared with nonusers. Aspirin use at entry was also associated with a 4-fold increase in risk of hemorrhagic stroke for both infrequent and frequent users of Aspirin (P=0.003). Aspirin use was associated with increased risks of ischemic stroke in women and hemorrhagic stroke overall in this elderly cohort. |
Ann Rev Public Health 1997 (18) 37: Aspirin in the treatment and prevention of cardiovascular disease *USA
Current data are inconclusive concerning Aspirin's effect on stroke and total vascular mortality. |
J Neurol Neurosurg Psychiatry 1996 60(2) 197: Aspirin at any dose above 30 mg offers only modest protection after cerebral ischaemia *THE NETHERLANDS
Virtually no difference in relative risk reduction for low, medium, and high doses of Aspirin (13%, 9%, and 14% respectively) |
IARC Sci Publ 1996 (139) 135: Adverse effects of preventive therapy in humans *ITALY
Aspirin is also associated with an increased risk of haemorrhagic stroke |
Nervenarzt 1995 66(12) 886 Disc. 885: High dosage acetylsalicylic acid administration for prevention of acute cerebral ischemia *GERMANY
Effect on secondary cerebral ischemic attacks after completed infarcts has not been sufficiently proven with the Aspirin. The preventive effect for cerebral ischemic attacks in normals without preceding strokes or TIA has not been shown. |
Ann Intern Med 1995 123(9) 649: Lack of effect of aspirin in asymptomatic patients with carotid bruits and substantial carotid narrowing. *CANADA
Aspirin did not have a significant long-term protective effect in asymptomatic patients with high-grade carotid stenosis |
BMJ 1994 308(6921) 81: Collaborative overview of randomised trials of antiplatelet therapy--I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Antiplatelet Trialists' Collaboration.
Among low risk recipients of "primary prevention" accompanied by a non-significant increase in stroke. Reduction in vascular events was much smaller despite a much longer treatment period (4.4% antiplatelet therapy vs 4.8% control, five years) |
J Neurol Neurosurg Psychiatry 1991 54(12) 1044: The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: final results. *UNITED KINGDOM
No difference in efficacy between the 300 mg and 1200 mg daily doses of Aspirin. No definite difference in males and females to Aspirin. No significant reduction in the likelihood of either disabling major stroke and vascular death or vascular death occurring. |
N Engl J Med 1991 325(18) 1261: A comparison of two doses of aspirin (30 mg vs. 283 mg a day) in patients after a transient ischemic attack or minor ischemic stroke. The Dutch TIA Trial Study Group. *THE NETHERLANDS
30 mg Aspirin daily is no less effective in vascular events than a 283-mg dose in patients with transient ischemic attack or minor stroke. |
Stroke 1991 22(7) 872: Cerebral hemorrhagic risk of aspirin or heparin therapy with thrombolytic treatment in rabbits **PHARMACOL
Compared to saline controls, Aspirin-only groups had a significantly higher incidence of cerebral hemorrhage, Aspirin antiplatelet therapy alone may increase the risk of hemorrhagic infarction. |
Ann Intern Med 1991 114(10) 835: Low-dose aspirin therapy for chronic stable angina. A randomized, placebo-controlled clinical trial *USA
Of 13 strokes, 11 occurred in the Aspirin group and 2 in the placebo group (relative risk, 5.4;p=0.02). 4 produced long-term impairment of function. Apparent increase in frequency of stroke with aspirin therapy |
Am J Med 1990 89(6) 772: Aspirin in the primary prevention of angina pectoris in a randomized trial of United States physicians *USA
Platelet inhibition with low-dose Aspirin (average 60.2 months) does not reduce incidence of angina pectoris. |
BMJ 1989 299(6710) 1247: Aspirin use and chronic diseases: a cohort study of the elderly. *USA
Risk of ischaemic heart disease almost doubled in those who took Aspirin daily compared with non-users. Non-significant increased risks of stroke in both sexes. |
N Engl J Med 1989 321(3) 129: Final report on the aspirin component of the ongoing Physicians' Health Study. Steering Committee of the Physicians' Health Study Research Group.
Increased risk of stroke among those taking aspirin was not statistically significant; primarily in subgroup with hemorrhagic stroke. No reduction in mortality from all cardiovascular causes associated with Aspirin. Evidence concerning stroke and total cardiovascular deaths remains inconclusive. |
Br Med J (Clin Res Ed) 1988 296(6618) 313: Randomised trial of prophylactic daily aspirin in British male doctors *UNITED KINGDOM
A six year rtrial among 5.139 healthy male doctors if 500 mg aspirin daily would reduce mortality from stroke, myocardial infarction or other vascular conditions: No significant difference in the incidence of non-fatal myocardial infarction or stroke. Disabling strokes somewhat commoner among those allocated Aspirin. Lack of any apparent reduction in disabling stroke. |
Stroke 1987 18(2) 325: High-dose acetylsalicylic acid after cerebral infarction. A Swedish Cooperative Study *SWEDEN
No difference in stroke recurrence rate in Aspirin and placebo groups. Transient ischemic attack was not reduced in Aspirin group. No prophylactic effect of high-dose Aspirin after cerebral infarction. |
Stroke 1983 14(1) 15: Acetylsalicylic acid in the prevention of stroke in patients with reversible cerebral ischemic attacks. A Danish cooperative study *DENMARK
Occurrence of transient ischemic attacks was not reduced by Aspirin treatment. Unable to demonstrate any favorable influence of Aspirin 1000 mg daily in patients with reversible ischemic attacks. |
Prostaglandins 1983 25(4) 549: Effects of aspirin and indomethacin on cerebral circulation in the conscious rat: evidence for a physiological role of endogenous prostaglandins **PHARMACOL
Aspirin after iv administration increased cerebral vascular resistances and decreased cerebral blood flow |
Surgery 1981 90(6) 1084: Aspirin failure in symptomatic atherosclerotic carotid artery disease *USA
Aspirin appeared to have a deleterious effect on these patients by allowing their carotid disease to progress to a dangerous state by eliminating the symptoms of progressive carotid artery atherosclerosis or by accentuating the process of atherosclerosis. |
J Clin Invest 1981 67(2) 503: Enhanced platelet accumulation onto injured carotid arteries in rabbits after aspirin treatment ** PHARMACOL
Margin of safety in obtaining an antithrombotic effect of Aspirin and producing a potential thrombotic effect in arteries may not be as large as predicted by studies using cultured endothelial cells or experimentally induced thrombosis in veins. |
Stroke 1977 8(3) 301: Controlled trial of aspirin in cerebral ischemia.*USA
No statistically significant difference between Aspirin and placebo treatment. It cannot be inferred from this study that aspirin prevents stroke. |
Neurology 1976 26(4) 297: Arachidonate-induced cerebrovascular occlusion in the rat. The role of platelets and aspirin in stroke. **PHARMACOL
Aspirin offered little protection against arachidonate-induced stroke |
*** |
Inhalt 
e-mail