Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, May 29, 2020

Aspirin doubles risk for upper GI bleeding events in older adults

Useless, we need to come up with an exact test that will identify those at risk instead of these blanket warnings.

 

Aspirin doubles risk for upper GI bleeding events in older adults

Andrew Chan headshot
Andrew T. Chan
Aspirin almost doubles the risk for serious upper gastrointestinal bleeding in older people and can further increase with age, smoking, chronic kidney disease and NSAIDs, according to data from Digestive Disease Week.
“This study confirms that among older adults, low dose aspirin is associated with an increased risk of gastrointestinal bleeding with the risk highest among those who smoke and have high blood pressure or kidney disease,” Andrew T. Chan, MD, chief, clinical and translational epidemiology unit director of cancer epidemiology at Massachusetts General Cancer Center, told Healio Gastroenterology.
Chan and colleagues assessed data on 19,114 patients from Aspree, an aspirin primary prevention trial. In the trial, 9,525 patients were randomly assigned to receive aspirin while 9,589 received placebo. Annually, investigators collected baseline clinical characteristics and a physician panel standardized and adjudicated GI bleeding events. The incidence of upper and lower GI bleeding was calculated. Then, predictors were identified with Cox regression analyses and the absolute risk for bleeding based on age and risk factors was modeled.

Aspirin almost doubles the risk for serious upper gastrointestinal bleeding in older people and can further increase with age, smoking, chronic kidney disease and NSAIDs.  Source: Adobe Stock
Of the 264 reported serious GI bleeding events, 137 were upper GI events (aspirin group n = 89, placebo group n = 48; HR = 1.87; 95% CI, 1.32-2.66) and 127 were lower GI events (aspirin group n = 73, placebo group n = 54; HR = 1.36; 95% CI, 0.96-1.94). Age, smoking, chronic kidney disease and NSAID use were risk factors for upper GI bleeding while age, smoking and hypertension were risk factors for lower GI bleeding, according to multivariate analyses. Proton pump inhibitor use was not linked to reduced bleeding events.
Chan and colleagues reported that the absolute, 5-year serious bleeding risk was 0.2% for 70-year-olds and 0.4% if patients were on aspirin, and up to 5.5% for 80-year-olds on aspirin with significant risk factors.
“Because this study was a rigorously performed randomized controlled trial, it provides more accurate estimates of the absolute risk of bleeding among individuals who initiate aspirin at an older age,” Chan said. “This will be useful for further studies to appropriately weigh the risks and benefits of low dose aspirin treatment.” – by Monica Jaramillo
Reference: Mahady SE, et al. Abstract 337. Presented at: Digestive Disease Week; May 2-5, 2020; Chicago (meeting canceled).

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