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Estimates of benefits and harms of prophylactic use of aspirin in the general population
Conclusions Prophylactic aspirin use for a minimum of 5 years at doses between 75 and 325 mg/day appears to have favourable benefit–harm profile; longer use is likely to have greater benefits. Further research is needed to determine the optimum dose and duration of use, to identify individuals at increased risk of bleeding, and to test effectiveness of Helicobacter pylori screening–eradication before starting aspirin prophylaxis.
Source: Annals of Oncology - December 17, 2014 Category: Cancer & Oncology Authors: Cuzick, J., Thorat, M. A., Bosetti, C., Brown, P. H., Burn, J., Cook, N. R., Ford, L. G., Jacobs, E. J., Jankowski, J. A., La Vecchia, C., Law, M., Meyskens, F., Rothwell, P. M., Senn, H. J., Umar, A. Tags: reviews Source Type: research

Predictors of Gastrointestinal Bleeding Among Patients with Atrial Fibrillation After Initiating Dabigatran Therapy
ConclusionThe risk of GI bleeding in patients receiving dabigatran is highly associated with increased age and cardiovascular, renal, and other comorbidities, even after adjusting for other factors. Fewer than 50% of patients restarted an anticoagulant after experiencing a GI bleed. Clinicians should continue to monitor for these risk factors or consider whether alternative therapies may be appropriate.
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - May 1, 2015 Category: Drugs & Pharmacology Authors: Julie C. Lauffenburger, Denise H. Rhoney, Joel F. Farley, Anil K. Gehi, Gang Fang Tags: Original Research Article Source Type: research

Nonsteroidal Anti-inflammatory Drug and Aspirin-induced Peptic Ulcer Disease.
Abstract Despite decreasing Helicobacter pylori prevalence, the prevalence of peptic ulcer disease is increasing in the aged population, mainly due to increasing use of NSAIDs to manage pain and inflammation. In addition, low dose aspirin is employed as an anti-coagulant for those who have suffered or are at high risk of ischemic stroke and cardiovascular disease. However, NSAIDs and aspirin are injurious to mucosa of stomach and duodenum. NSAID-induced inhibition of mucosal prostaglandin synthesis is thought to be a major mechanism of gastrointestinal mucosal injury. The proportion of elderly has increased rapidl...
Source: Korean J Gastroenter... - June 19, 2016 Category: Gastroenterology Authors: Shim YK, Kim N Tags: Korean J Gastroenterol Source Type: research

Gastrointestinal bleeding in patients on novel oral anticoagulants: Risk, prevention and management.
Abstract Novel oral anticoagulants (NOACs), which include direct thrombin inhibitor (dabigatran) and direct factor Xa inhibitors (rivaroxaban, apixaban and edoxaban), are gaining popularity in the prevention of embolic stroke in non-valvular atrial fibrillation as well as in the prevention and treatment of venous thromboembolism. However, similar to traditional anticoagulants, NOACs have the side effects of bleeding, including gastrointestinal bleeding (GIB). Results from both randomized clinical trials and observations studies suggest that high-dose dabigatran (150 mg b.i.d), rivaroxaban and high-dose edoxaban (6...
Source: World Journal of Gastroenterology : WJG - March 21, 2017 Category: Gastroenterology Authors: Cheung KS, Leung WK Tags: World J Gastroenterol Source Type: research

Increased susceptibility of aging gastric mucosa to injury and delayed healing: Clinical implications.
Abstract In this editorial we comment on the article by Fukushi K et al published in the recent issue of the World Journal of Gastroenterology 2018; 24(34): 3908-3918. We focus specifically on the mechanisms of the anti-thrombotic action of aspirin, gastric mucosal injury and aging-related increased susceptibility of gastric mucosa to injury. Aspirin is widely used not only for the management of acute and chronic pain and arthritis, but also importantly for the primary and secondary prevention of cardiovascular events such as myocardial infarcts and strokes. Clinical trials have consistently shown that antiplatele...
Source: World Journal of Gastroenterology : WJG - November 14, 2018 Category: Gastroenterology Authors: Tarnawski AS, Ahluwalia A Tags: World J Gastroenterol Source Type: research