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Evidence summaries

Risk of Gastrointestinal Haemorrhage with Long Term Use of Aspirin as an Antiplatelet Agent

Long-term therapy with aspirin as an antiplatelet agent is associated with increas in the incidence of gastrointestinal haemorrhage (2.47% versus 1.42% on placebo), based on an average of 28 months therapy. Level of evidence: "A"

A systematic review 1 including 24 studies with a total of 65 987 subjects was abstracted in DARE.

All 24 trials were double-blind and placebo-controlled. Gastrointestinal haemorrhage occurred in 2.47% of patients taking aspirin compared with 1.42% taking placebo (OR 1.68, 95% CI1.51 to 1.88). The NNH was 106 (95% CI 82 to 140), based on an average of 28 months therapy.

At doses below 163 mg/day, gastrointestinal haemorrhage occurred in 2.30% of patients taking

aspirin, compared with 1.45% taking placebo (OR 1.59, 95% CI 1.40 to 1.81). Meta-regression showed no relation between gastrointestinal haemorrhage and dose. Omitting the two largest trials did not significantly change the results.

    References

    • Derry S, Loke YK. Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis. BMJ 2000 Nov 11;321(7270):1183-7. [PubMed][DARE]

Primary/Secondary Keywords