Objective To improve the knowledge of epidemiology, diagnosis and treatment of aspirin induced asthma ( AIA) in China. Methods Thirty-six cases with AIA who were reported in 30 papers in recent 10 years were analyzed retrospectively. Results The drugs which induced AIA in China mainly included acetylsalicylic acid ( aspirin) , ibuprofen ( Fenbid, ibuprofen) , while acetaminophen ( paracetamol,Bufferin, Tylenol ) , phenylpropanoid thiazide ( Piroxicam) , methoxy-naphthalene C acid ( naproxen) ,diclofenac in rare cases. 28. 6% ( 8 /28) of AIA patients were complicated with nasal disease . AIA could occur at all ages, especially for those over 40 years ( 72. 2% , 26 /36) . No significant difference of prevalencein male and female. The onset time of AIA was less than 60min in 71. 4% and gt;120min in 38. 6% . Most patients took the medications by oral ( 83. 3% ,30/36) , but the AIA onset time was not different by different administration route. Conclusions The incidence of AIA increases in recent years because of widely use of NSAIDs. However, no awareness of NSAIDs induced asthma is common in patients and physicians. For asthma patients it must be caution to take antipyretic analgesic anti-inflammatory drugs. If necessary,methoxy-naphthalene C acid ( naproxen) and diclofenac could be better choice.
Objective To compare the efficacy and safety of aspirin and rivaroxaban in the prevention of venous thromboembolism (VTE) after total knee arthroplasty (TKA). Methods Eight databases were searched, including Cochrane Library, Embase, Web of Science, PubMed, SinoMed, Wanfang, Chongqing VIP, and China National Knowledge Infrastructure. The search period was from the establishment of databases to June 2023. All randomized controlled trials of aspirin and rivaroxaban for the prevention of VTE after TKA were collected, and meta-analysis was conducted using RevMan 5.3 software. Results A total of 7 articles were included, with a publication period from 2014 to 2022, including a total of 714 patients, including 356 in the aspirin group and 358 in the rivaroxaban group. The meta-analysis results showed that the incidence of deep venous thrombosis in the lower limbs of the aspirin group was higher than that of the rivasarb group [relative risk (RR)=1.53, 95% confidence interval (CI) (1.09, 2.16), P=0.01], and the incidence of bleeding complications was lower than that of the rivaroxaban group [RR=0.66, 95%CI (0.52, 0.82), P=0.0003]. There was no statistically significant difference in the incidence of wound complications between the two groups (P>0.05). Conclusion The efficacy of rivaroxaban in preventing VTE after TKA is better than that of aspirin, but there is an increased risk of bleeding complications.
【摘要】 目的 比较薤白联合阿司匹林或单用阿司匹林防治心脑血管事件的疗效。 方法 2007年1月〖CD3/5〗2009年9月就诊的188例高危患者纳入研究,随机分为实验组(89例)和对照组(99例)。两组均予口服阿司匹林0.1 g,1次/d。实验组同时给予口服薤白0.9 g,3次/d。观察两组患者血管事件的发生率和不良反应的发生情况。 结果 实验组血管总事件发生率为6.7%,对照组为19.2%,两组间差异有统计学意义(Plt;0.05);实验组脑梗死发生率为1.1%,对照组为9.1%,两组间差异有统计学意义(Plt;0.05)。两组短暂性脑缺血、心绞痛、心肌梗死的发生率比较,差异无统计学意义(Pgt;0.05)。两组皮下出血、血尿、黑便、恶心、腹痛等不良反应的发生率比较,差异无统计学意义(Pgt;0.05)。 结论 服用阿司匹林加薤白可显著降低高危患者心脑血管总事件发生率和脑梗死发生率,增加疗效,而不良反应没有显著增加。【Abstract】 Objective Compare the curative effect of cerebrovascular diseases event prevented with llium macrostemon and aspirin or only with aspirin. Methods Divide the outpatient patients into experimental group (89 patients) and control group (99 patients). Use 0.1 g aspirin for two groups with oral administration once per day. The experimental group is used with 0.9 g allium macrostemon with oral administration three times per day. Observe the generation rate and adverse reaction of vascular events in two groups of patients. Results The Total generation rate of vascular events in the experimental group is 6.7% and the control group is 19.2%,the differences were statistically significant (Plt;0.05); the cerebral infarction generation rate in the experimental group is 1.1% and in the control group is 9.1%,the differences were statistically significant (Plt;0.05). There is no significant difference (Pgt;0.05) in TIA, angina pectoris, myocardial infarction generation rate in two groups. There is no significant difference (Pgt;005) in adverse reaction generation rate of subcutaneous hemorrhage, hematuria, melena, nausea, bellyache. Conclusion Taking aspirin with llium macrostemon can significantly decrease total cardiovascular and cerebrovascular events generation rate and cerebral infarction generation rate in high risk patients, improve the curative effect and the adverse reaction has not been significantly increased.
ObjectivesTo systematically review the safety and efficacy of aspirin in primary prevention of cardiovascular diseases.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of aspirin for primary prevention of cardiovascular diseases from inception to November 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, and then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 13 RCTs involving 164 225 participants were included. The results of meta-analysis showed that: aspirin reduced the risk of myocardial infarction (RR=0.85, 95%CI 0.75 to 0.97, P=0.01), ischemic stroke (RR=0.86, 95%CI 0.79 to 0.95, P=0.002) and risk of major adverse cardiovascular events (RR=0.90, 95%CI 0.86 to 0.94, P<0.000 1). However, all-cause mortality (RR=0.97, 95%CI 0.93 to 1.02, P=0.22) and cardiovascular mortality (RR=0.93, 95%CI 0.85 to 1.02, P=0.11) were not reduced. Additionally, it increased risk of hemorrhagic stroke (RR=1.29, 95%CI 1.02 to 1.64, P=0.03), major bleeding (RR=1.43, 95%CI 1.31 to 1.56, P<0.000 01) and gastrointestinal bleeding (RR=1.59, 95%CI 1.33 to 1.90, P<0.000 01).ConclusionCurrent evidence shows that aspirin can reduce the incidence of major adverse cardiovascular events and myocardial infarction during primary prevention of cardiovascular disease, while increase the risk of bleeding, especially gastrointestinal bleeding. Therefore, its potential benefits may be offset. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.
Objective To systematically assess the clinical efficacy and safety of cilostazol for preventing ischemic stroke recurrence. Methods Such databases as PubMed, The Cochrane Library, EMbase, CNKI, CBM, and VIP were searched for randomized controlled trials (RCTs) on the use of cilostazol to prevent ischemic stroke recurrence (up to November, 2010). Two researchers selected studies and extracted data independently using a designed extraction form. The quality of included trials was evaluated and RevMan 5.0 software was used for meta-analyses. Results Four RCTs involving 3 916 patients were included. The results of meta-analyses showed that there were significant differences between cilostazol and aspirin in terms of hemorrhagic stroke occurrence (RR=0.39, 95%CI 0.24 to 0.61, Plt;0.000 1), headache occurrence (RR=1.99, 95%CI 1.16 to 3.43, P=0.01) and dizziness occurrence (RR=1.43, 95%CI 1.13 to 1.79, P=0.002). Whereas, no significant difference was found between the two groups in terms of ischemic stroke recurrence (RR=0.80, 95%CI 0.61 to 1.04, P=0.10) and transient ischemic attack occurrence (RR=0.93, 95%CI 0.45 to 1.92, P=0.85). Conclusion The current evidence indicates that cilostazol is as effective as aspirin in preventing ischemic stroke recurrence, but with less incidence of hemorrhagic stroke.
Abstract: Coronary artery bypass grafting (CABG) has become more and more popular, but how to decrease the thrombotic stenosis of saphenous vein grafts remains a tough problem clinically. Some researchers raised that aspirin resistance (AR) may be one of the most principal causes of graft thrombus and many correlative studies have been reported in recent years．In this article, we reviewed and analyzed the concept and evaluation criterion, incidence rate, mechanisms, clinic significance, and preventing strategy of AR, expecting to deepen the understanding of AR and help to optimize the antiplatelet therapy for postCABG patients with AR.
ObjectiveTo compare early postoperative outcomes of Chinese patients undergoing off-pump coronary artery bypass grafting (OPCAB) with or without preoperative discontinuation of aspirin. MethodsClinical data of 354 patients who underwent elective OPCAB in Department of Cardiac Surgery, People's Hospital of Peking University from 2011 to 2012 were retrospectively analyzed. There were 132 patients during year 2011 who discontinued aspirin more than 5 days before OPCAB and were defined as a discontinuation group, including 93 males and 39 females with their age of 36-83 (61.70±8.74) years. There were 222 patients during year 2012 who continued aspirin treatment before OPCAB and were defined as an aspirin group, including 162 males and 60 females with their age of 37-82 (63.26±8.94) years. Postoperative chest drainage, incidence of reexploration for bleeding, in-hospital morbidity and mortality were compared between the 2 groups. Serum cardiac troponin I (cTnI) levels during 4-6 hours, 12-18 hours and 24-48 hours after OPCAB were also compared. ResultsPreoperative clinical characters were not statistically different between the 2 groups (P>0.05). Average number of grafts in the discontinuation group was significantly smaller than that in the aspirin group (3.00±0.89 vs. 3.43±0.93, P=0.001). There was no significant difference in postoperative chest drainage (1 063.75±511.50 ml vs. 1 131.35±460.13 ml, P=0.201), incidence of reexploration for bleeding(0 case vs. 1 case, P=1.000), perioperative myocardial infarction(2 cases vs. 1 case, P=0.647), postoperative acute renal failure(4 cases vs. 7 cases, P=1.000), stroke(1 case vs. 4 cases, P=0.726), mechanical ventilation time(41.46±85.50 hours vs. 52.07±143.59 hours, P=0.441), length of ICU stay(81.46±116.90 hours vs. 79.07±136.43 hours, P=0.867), or in-hospital mortality(0.8% vs. 0.9%, P=1.000)between the 2 groups. Serum cTnI levels during 4-6 hours after OPCAB were not statistically different between the 2 groups (P=0.506). Serum cTnI levels during 12-18 hours and 24-48 hours after OPCAB were statistically different between the 2 groups (P=0.002 and P=0.000). The percentages of patients with cTnI level higher than 4.0 ng/ml during 12-18 hours and 24-48 hours after OPCAB in the aspirin group were significantly lower than those in the discontinuation group (5.4% vs. 16.7%, P=0.001;5.9% vs. 17.4%, P=0.000). ConclusionOPCAB without preoperative discontinuation of aspirin does not increase the risk of postoperative bleeding, in-hospital morbidity or mortality, but can decrease postoperative myocardial injury of Chinese patients undergoing OPCAB.
OBJECTIVE: To evaluate the effect of low-dose aspirin on the deposition of platelet at the anastomotic site and the function of coagulation system in order to provide experimental data for clinical use. METHODS: (1) Twenty-eight SD rats were divided into experimental group (n = 21) and control group (n = 7), aspirin were administered through a catheter placed in the femoral vein in dose of 4 mg/kg in the experimental group and the same dose of normal saline in the control group. The experimental group was subdivided into 3 groups, with 7 rats in each group, according to survival time of 24, 48 and 72 hours after dose. Samples of 4 ml blood were taken by heart puncture from each rat to investigate the maximal platelet aggregation rate(MAR), prothrombin time(PT) and kaolin partial thromboplastin time(KPTT). (2) Sixteen New Zealand White rabbits were divided into experimental and control group, 8 rabbits in each group. Drugs were given in the same way. Forty-eight hours later, the bilateral femoral arteries of each rabbit were exposed and arteries between inguinal ligament and the origin of the superficial epigastric arteries were transected and end-to-end anastomosis was completed with interrupted suturing technique. Fifteen and 120 minutes after the recovery of blood flow, the left and the right vessels containing anastomotic sites were harvested respectively and treated with 125I-labeled anti-GP IIb/III a antibody (SZ-21) using radioimmunobinding method. The radioactivities of the anastomosed vessels were measured. RESULTS: The KPTT in the experimental group was longer than that of the control group at 24- and 48-hour group, the mean percentages of increase were 42.56% and 35.33% respectively, and there were very significant differences between the experimental and control group in 24-hour group (P lt; 0.001). The PT value in experimental group was longer than that of the control group, but there was no significant difference (P gt; 0.05), and the maximal aggregation rate of platelet in the experimental group was significantly lower than that of the control group after 72 hours (P lt; 0.001). The radioactivity of the anastomosed arteries in the experimental group were significantly higher than that of the control group (P lt; 0.001) at 15 minutes after the recovery of blood flow, the mean percentage of increase was 110%. CONCLUSION: Low-dose aspirin can significantly affect the function of the intrinsic coagulation system, prevent the aggregation of platelets, but no effect on the function of the extrinsic coagulation system. On the other hand, it can also increase the deposition of platelet on the anastomotic sites after end-to-end anastomosis, especially in the early stage when it is intravenously injected, but it is b enough to cause thrombosis at the anastomotic sites. The effects of low dose aspirin on the coagulation system are inconsistent with its local effects on anastomotic sites.
ObjectiveTo understand the situation of off-label use of aspirin among outpatients in Sun Yatsen Memorial Hospital, so as to provide baseline data for developing off-label drug use policy. MethodsA stratified random sampling method was used to collected prescription data of aspirin among outpatients in 2013. The incidence rates between different types of off-label use of aspirin were determined by chi-square test, and the influence factors of off-label drug use were analyzed by logistic regression model. ResultsA total of 5 023 prescriptions with aspirin were collected and analyzed, with incidence rate of off-label use up to 17.7%. The major category of off-label use was no indication (94.38%). The top 3 no indications were recurrent abortion, infertility and systemic lupus erythematosus. Drug specification, gender, age and prescribed department were the risk factors of off-label use. ConclusionAspirin off-label use is common among outpatients in Sun Yat-sen Memorial Hospital in 2013, especially in obstetrics and gynecology department and assisted reproductive center. The results suggest that more clinical studies about aspirin for reproduction are needed to provide more evidence of drug use, so as to ensure the safety of drug use in special populations and avoid potential medical risk.