PMID- 23413984
OWN - NLM
STAT- MEDLINE
DCOM- 20130905
LR  - 20131121
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 37
IP  - 7
DP  - 2013 Apr
TI  - The aspirin cardiovascular/gastrointestinal risk calculator--a tool to aid 
      clinicians in practice.
PG  - 738-48
LID - 10.1111/apt.12240 [doi]
AB  - BACKGROUND: Assessment of both GI and CV risks vs. the benefits of low-dose 
      aspirin for individual patients can be difficult in clinical practice. AIM: To 
      develop a tool to estimate CV and GI risks to facilitate the clinical 
      decision-making process. METHODS: We constructed risk-ratio estimations and 
      determined the incidence of CV events and upper GI complications according to the 
      presence of different risk factors. For upper GI complications we assumed a 
      baseline incidence of 1 case/1000-persons-year, a twofold increased risk with 
      low-dose aspirin, and estimated a 60% GI risk reduction with proton pump 
      inhibitors (PPI) co-therapy and a 60% risk reduction with H. pylori eradication 
      in patients with a history of peptic ulcer. RESULTS: The calculator can be found 
      at http://www.asariskcalculator.com. In patients with low CV risk the number of 
      GI complications induced by low-dose aspirin may be greater than the number of CV 
      events prevented. In patients with high CV risk, low-dose aspirin is recommended, 
      but the number of GI complications induced may still overcome the CV events 
      saved. The use of PPI reduces the number of complication events induced by 
      low-dose aspirin, but the number of CV events saved may still be offset by the 
      number of GI complications induced in patients at very high GI risk. CONCLUSIONS: 
      There are many clinical situations where the number of potential upper GI 
      complications induced by low-dose aspirin may exceed the number of potentially 
      prevented CV events. A risk calculator should guide physicians in choosing 
      appropriate therapy and maximise the aspirin benefit.
CI  - (c) 2013 Blackwell Publishing Ltd.
FAU - Lanas, A
AU  - Lanas A
AD  - Service of Digestive Diseases, University Hospital Lozano Blesa, University of 
      Zaragoza, IIS Aragon, Spain. alanas@unizar.es
FAU - Polo-Tomas, M
AU  - Polo-Tomas M
FAU - Casado-Arroyo, R
AU  - Casado-Arroyo R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130217
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
CIN - Aliment Pharmacol Ther. 2013 Jun;37(11):1115. PMID: 23656421
CIN - Aliment Pharmacol Ther. 2013 Jun;37(11):1116. PMID: 23656423
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Algorithms
MH  - Aspirin/administration & dosage/*adverse effects
MH  - Cardiovascular Diseases/*chemically induced/prevention & control
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Gastrointestinal Hemorrhage/*chemically induced/prevention & control
MH  - Gastrointestinal Tract/drug effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/administration & dosage/*adverse effects
MH  - Proton Pump Inhibitors/administration & dosage
MH  - Risk Assessment/methods
MH  - Risk Factors
MH  - Young Adult
EDAT- 2013/02/19 06:00
MHDA- 2013/09/06 06:00
CRDT- 2013/02/19 06:00
PHST- 2012/10/10 00:00 [received]
PHST- 2012/11/06 00:00 [revised]
PHST- 2013/01/21 00:00 [revised]
PHST- 2013/01/21 00:00 [accepted]
PHST- 2013/02/19 06:00 [entrez]
PHST- 2013/02/19 06:00 [pubmed]
PHST- 2013/09/06 06:00 [medline]
AID - 10.1111/apt.12240 [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2013 Apr;37(7):738-48. doi: 10.1111/apt.12240. Epub 2013 
      Feb 17.