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Interact CardioVasc Thorac Surg 2007;6:519-522. doi:10.1510/icvts.2007.155788
© 2007 European Association of Cardio-Thoracic Surgery
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Best evidence topic - Coronary

Does enteric-coated aspirin result in a lower incidence of gastrointestinal complications compared to normal aspirin?

Jay Walkera, James Robinsona, Jamie Stewarta and Samuel Jacobb,*

a Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, UK
b Department of Cardiothoracic Surgery, Aberdeen Royal Infirmary, Aberdeen, UK

*Corresponding author. Tel.: +44 (0)7710272021.

E-mail address: drsamueljacob{at}doctors.org.uk (S. Jacob).

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether enteric-coated aspirin results in a lower incidence of gastrointestinal complications compared to normal aspirin in CABG surgery. Using the reported search, 340 papers were identified. Nine papers represented the best evidence on the subject. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, weaknesses, results and study comments were tabulated. Five randomised controlled trials of healthy volunteers undergoing endoscopy after a period of either enteric-coated aspirin or plain aspirin administration all demonstrated a clear reduction of gastric mucosal injury. However, these trials on healthy volunteers taking short-term aspirin have not been supported by clinical studies in older age-group adults taking lower doses of aspirin for long periods. No clinical benefits in terms of reduction of gastrointestinal bleeding or ulceration with enteric coating have, therefore, been successfully demonstrated, although the endoscopic studies show that potentially these benefits could exist.

Key Words: Aspirin; Enteric coated tablets; Gastrointestinal complications; Coronary artery bypass grafts

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