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CC Jan 2017 Prophylactic Aspirin Therapy

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echoecho's version from 2017-03-05 22:31

Section

Question Answer
Aspirin has been shown in multiple studies to help reduce the risk of _____ and _____, although preventive effects vary based on the age and o-morbid conditions of the study populations?1) CVD. 2) colorectal cancer
What is the reason that ASA reduces cardiovascular risk?ASA inhibits COX-1 generated thromboxane A2 (TXA2)
What is the reason that ASA reduces colorectal cancer?Less understood but it is hypothesized that ASA reduces prostaglandin synthesis and contributes to colorectal preventive properties
*** In April 2016, the USPSTF released revised recommendations regarding use of ASA (previous 2013 recommendations was for ASA use to reduce the risk of MI in men 45-79 yrs of age and ischemic stroke in women 55-79 years of age), what are the new guidelines?1) initiate low-dose ASA for the primary prevention of CVD and CRC in adults aged 50-59 years old who (A) have a > 10% or greater 10-year CVD risk (B) are NOT at increased risk for bleeding. (C) have a life expectancy of at least 10 years and (D) are willing to take low-dose ASA daily for at least 10 years
*** The above April 2016 guidelines are rated Grade B, what does this mean?Service recommended; there is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial
The decision to initiate low-dose ASA use for primary prevention of CVD and CRC in adults aged 60-69 y.o. Who have a > 10% 10-year CVD risk should be an _______ one?individual
What type of patient regarding above question are more likely to benefit?1) persons who are NOT at increased risk of bleeding. 2) have a life expectancy of at least 10 years. 3) willing to take low-dose ASA daily for at least 10 years.
Persons who place a higher value on the potential benefits than the potential harms may choose to initiate low dose ASA. This is a grade C recommendation, what does this mean?recommendation against routinely providing the service; there is a moderate to high certainty that the service has no net benefit or that the harms outweigh the benefits
The USPSTF finds insufficient evidence to recommend the use of ASA for prevention of cardiovascular disease and colorectal cancer for thos < ____ or > ____ there's of age. This is a grade 1 recommendation, what does that mean?50; 70; insufficient evidence or evidence of poor quality
Low dose ASA is considered _____ mg per day, although other doses (75 mg or 325 mg) also appear effective?81
Low dose ASA is associated with an increased risk of _____ bleeding and _____ stroke?1)GI. 2)hemorrhagic
List risk factors to bleeding?(1) previous bleeding. (2) the use of anticoagulant / antiplatelet agents (3) vascular disease
The risk of bleeding is small in individuals < ____ years of age and small to moderate in those ____ to ____ years of age?59; 60; 69
USPSTF found inadequate evidence to determine harms in those > ____ years of age?70
Does ASA therapy alter glucose control?no
*** SUMMARY = Initiate low-dose ASA for the primary prevention of CVD and CRC in adults aged ____ to ____ years who have a 10 year CVD risk > 10%, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose ASA daily for at least 10 years?50; 59
*** SUMMARY = The decision to initiate low-dose ASA use for the primary prevention of CVD and CRC in adults aged 60-69 years who have a 10 year CVD risk > 10% should be an __________ one?individual
*** SUMMARY = There is insufficient evidence to recommend the use of ASA for the prevention of CVD and CRC for those < _____ years or > ____ years of age?50; 70
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