Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis
BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7270.1183 (Published 11 November 2000) Cite this as: BMJ 2000;321:1183
Data supplement
Table 1 Additional details on the included studies
Study
Year Age (mean or range, years) Male (%) Definition of haemorrhage Loss to follow up (%) Concealment of allocation Diener et alw1 w2 1996 66 58 Haematemesis and/or melaena <1 Adequate Hansson et alw3 1998 61.5 53 Gastrointestinal bleed 2.6 Adequate Petersen et alw4 1989 75 54 Gastrointestinal bleed Unclear Adequate SALTw5 1991 67 66 Gastrointestinal bleed <1 Adequate TPTw6 1998 45-69 100 Gastrointestinal bleed 1 Adequate Wallentinw7 1991 58 100 Gastrointestinal bleed 0 Unclear Silagy et alw8 1993 73 49 Haematemesis and/or melaena 0 Unclear USPHSw9 1989 40-84 100 Haematemesis and/or melaena Unclear Adequate EAFTw10 1993 73 55 Gastrointestinal bleed <1 Adequate Elwood et alw11 1974 55 100 Gastrointestinal haemorrhage Unclear Unclear UKTIAw12 1991 60 73 Gastrointestinal bleed 0 Adequate Gavaghan et alw13 1991 56 85 Gastrointestinal bleed <1 Unclear Olivotto et alw14 1996 53 0 Gastrointestinal bleed Unclear Unclear Elwood et alw15 1979 56 85 Gastrointestinal bleed 0 Unclear CDPAw16 1976 60%>55 100 Haematemesis and/or melaena Unclear Unclear PARISw17 1980 30-74 81 Gastrointestinal bleed 6.7 Adequate Hess et alw18 1985 62 80 Gastrointestinal bleed 0 Unclear AMISw19 1980 54 89 Haematemesis and/or melaena <1 Unclear Breddin et alw20 1980 40-70 79 Gastrointestinal haemorrhage 9.6 Adequate CCSGw21 1978 Unclear 67 Haematemesis and/or melaena <1 Adequate Fields et alw22 1977 >45 66 Gastrointestinal bleed 5 Adequate Fields et alw23 1978 >45 74 Gastrointestinal haemorrhage Unclear Adequate Brittonw24 1987 68 62 Gastrointestinal haemorrhage Unclear Adequate Ehresman et alw25 1977 59 94 Gastrointestinal bleed 11.2 Unclear SALT=Swedish aspirin low dose trial; TPT=thrombosis prevention trial; USPHS=US physicians health study; EAFT=European atrial fibrillation trial; UK TIA=UK transient ischaemic attack aspirin trial; CDPA=coronary drug project aspirin study; PARIS=persantine-aspirin reinfarction study; AMIS=aspirin myocardial infarction study; CCSG=Canadian Cooperative Study Group.
Funnel plot of Peto odds ratio against the inverse standard error
w1 Diener HC, Cunha L, Forbes C, Sivenius J, Smets P, Lowenthal A. European stroke prevention study. 2: Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci 1996;143:1-13.
w2 Diener HC, Forbes C, Riekkinen PJ, Sivenius J, Smets P, Lowenthal A. European stroke prevention study. 2: Efficacy and safety data: the ESPS 2 group. J Neurol Sci 1997;151(suppl):S1-61.
w3 Hansson L, Zanchetti A, Carruthers SG, Dahlof B, Elmfeldt D, Julius S, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomised trial. HOT Study Group. Lancet 1998;351:1755-62.
w4 Petersen P, Boysen G, Godtfredsen J, Andersen ED, Andersen B. Placebo-controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. The Copenhagen AFASAK study. Lancet 1989;1:175-9.
w5 SALT Collaborative Group. Swedish aspirin low-dose trial (SALT) of 75 mg aspirin as secondary prophylaxis after cerebrovascular ischaemic events. Lancet 1991;338:1345-9.
w6 Thrombosis prevention trial: randomised trial of low-intensity oral anticoagulation with warfarin and low-dose aspirin in the primary prevention of ischaemic heart disease in men at increased risk. The Medical Research Council's General Practice Research Framework. Lancet 1998;351:233-41.
w7 Wallentin LC. Aspirin (75 mg/day) after an episode of unstable coronary artery disease: long-term effects on the risk for myocardial infarction, occurrence of severe angina and the need for revascularization. Research Group on Instability in Coronary Artery Disease in Southeast Sweden. J Am Coll Cardiol 1991;18:1587-93.
w8 Silagy CA, McNeil JJ, Donnan GA, Tonkin AM, Worsam B, Campion K. Adverse effects of low-dose aspirin in a healthy elderly population. Clin Pharmacol Ther 1993;54:84-9.
w9 Steering Committee of the Physicians' Health Study Research Group. Final report on the aspirin component of the ongoing physicians' health study. N Engl J Med 1989;321:129.
w10 EAFT (European Atrial Fibrillation Trial) Study Group. Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. Lancet 1993;342:1255-62.
w11 Elwood PC, Cochrane AL, Burr ML, Sweetnam PM, Williams G, Welsby E, et al. A randomized controlled trial of acetyl salicylic acid in the secondary prevention of mortality from myocardial infarction. BMJ 1974;1:436-40.
w12 Farrell B, Godwin J, Richards S, Warlow C. The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: final results. J Neurol Neurosurg Psychiatry 1991; 54:1044-54.
w13 Gavaghan TP, Gebski V, Baron DW. Immediate postoperative aspirin improves vein graft patency early and late after coronary artery bypass graft surgery. A placebo-controlled, randomized study. Circulation 1991;83:1526-33.
w14 Olivotto IA, Kim-Sing C, Bajdik CD, Trevisan CH, Ludgate CM, Weir LM, et al. Effect of acetylsalicylic acid on radiation and cosmetic results after conservative surgery for early breast cancer: a randomized trial. Radiother Oncol 1996;41:1-6.
w15 Elwood PC, Sweetnam PM. Aspirin and secondary mortality after myocardial infarction. Lancet 1979;2:1313-5.
w16 Coronary Drug Project Research Group. Aspirin in coronary heart disease. J Chronic Dis 1976;29:625-42.
w17 Persantine-Aspirin Reinfarction Study Research Group. Persantine and aspirin in coronary heart disease. Circulation 1980;62:449-61.
w18 Hess H, Mietaschk A, Deichsel G. Drug-induced inhibition of platelet function delays progression of peripheral occlusive arterial disease. A prospective double-blind arteriographically controlled trial. Lancet 1985;1:415-9.
w19 Aspirin Myocardial Infarction Study Research Group. The aspirin myocardial infarction study: final results. Circulation 1980;62(6, part 2):V79-84.
w20 Breddin K, Loew D, Lechner K, Uberla K, Walter E. Secondary prevention of myocardial infarction: a comparison of acetylsalicylic acid, placebo and phenprocoumon. Haemostasis 1980;9:325-44.
w21 Canadian Cooperative Study Group. A randomized trial of aspirin and sulfinpyrazone in threatened stroke. N Engl J Med 1978;299:53-9.
w22 Fields WS, Lemak NA, Frankowski RF, Hardy RJ. Controlled trial of aspirin in cerebral ischemia. Stroke 1977;8:301-14.
w23 Fields WS, Lemak NA, Frankowski RF, Hardy RJ. Controlled trial of aspirin in cerebral ischemia. Part II: surgical group. Stroke 1978;9:309-19.
w24 Britton M, Helmers C, Samuelsson K. High-dose acetylsalicylic acid after cerebral infarction. A Swedish cooperative study. Stroke 1987;18:325-34.
w25 Ehresmann U, Alemany J, Loew D. Prophylaxe von Rezidivverschlussen nach Revaskularisations-eingriffen mit Acetylsalicylsaure. Ergebnisse einer doppeltblinden Langzeitstudie. Med Welt 1977;28:1157-62.
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