000056810 001__ 56810
000056810 005__ 20200221144347.0
000056810 0247_ $$2doi$$a10.1371/journal.pone.0160046
000056810 0248_ $$2sideral$$a96375
000056810 037__ $$aART-2016-96375
000056810 041__ $$aeng
000056810 100__ $$aRodríguez, L.A.G.
000056810 245__ $$aBleeding risk with long-term low-dose aspirin: A systematic review of observational studies
000056810 260__ $$c2016
000056810 5060_ $$aAccess copy available to the general public$$fUnrestricted
000056810 5203_ $$aBackground Low-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. Methods Systematic 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. Findings The incidence of GI bleeding with low-dose aspirin was 0.48-3.64 cases per 1000 personyears, 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. Conclusions The 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.
000056810 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000056810 590__ $$a2.806$$b2016
000056810 591__ $$aMULTIDISCIPLINARY SCIENCES$$b15 / 63 = 0.238$$c2016$$dQ1$$eT1
000056810 592__ $$a1.236$$b2016
000056810 593__ $$aAgricultural and Biological Sciences (miscellaneous)$$c2016$$dQ1
000056810 593__ $$aMedicine (miscellaneous)$$c2016$$dQ1
000056810 593__ $$aBiochemistry, Genetics and Molecular Biology (miscellaneous)$$c2016$$dQ1
000056810 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000056810 700__ $$aMartín-Pérez, M.
000056810 700__ $$aHennekens, C.H.
000056810 700__ $$aRothwell, P.M.
000056810 700__ $$0(orcid)0000-0001-5932-2889$$aLanas, A.$$uUniversidad de Zaragoza
000056810 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000056810 773__ $$g11, 8 (2016), 0160046 [20 pp]$$pPLoS One$$tPloS one$$x1932-6203
000056810 8564_ $$s2004293$$uhttps://zaguan.unizar.es/record/56810/files/texto_completo.pdf$$yVersión publicada
000056810 8564_ $$s99108$$uhttps://zaguan.unizar.es/record/56810/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000056810 909CO $$ooai:zaguan.unizar.es:56810$$particulos$$pdriver
000056810 951__ $$a2020-02-21-13:53:10
000056810 980__ $$aARTICLE