Cardiovascular Drugs and Therapy

, Volume 25, Issue 6, pp 551–560

Prospective Cohort Study of Gastrointestinal Complications and Vascular Diseases in Patients Taking Aspirin: Rationale and Design of the MAGIC Study

  • Hideki Origasa
  • Shinya Goto
  • Kazuyuki Shimada
  • Shinichiro Uchiyama
  • Yasushi Okada
  • Kentaro Sugano
  • Hideyuki Hiraishi
  • Naomi Uemura
  • Yasuo Ikeda
  • on behalf of the MAGIC Investigators



Although aspirin has been widely prescribed for the prevention of cardiovascular events, its risk of gastrointestinal complications is of great concern. Despite expectations for such, few data are available on the prevalence or incidence of gastrointestinal complications in aspirin users in Japan. The Management of Aspirin-induced GastroIntestinal Complications (MAGIC) is the first attempt at collaboration among cardiologists, neurologists, and gastroenterologists to obtain such findings. We aim to share all about the MAGIC study.


The MAGIC is a prospective cohort study involving patients taking low-dose aspirin (81 mg to 325 mg per day) for longer than 1 month. Participants are recruited from multiple disease categories, including those with coronary artery disease, cerebrovascular disease, atrial fibrillation, and other cardiovascular conditions requiring antithrombotic therapy. Its duration of follow-up is 1 year. At baseline and 1 year follow-up, all participants will undergo endoscopic examination. The primary outcome is upper gastrointestinal complications, classified as erosions, ulcers, and bleeding. Secondary outcomes include LANZA score, non-fatal cardiovascular events, any bleeding, cancer, and death.


1,533 participants were entered in the MAGIC cohort. By underlying disease, about 45% of them had coronary artery diseases, followed by cerebrovascular diseases (35%), atrial fibrillation (10%) and other cardiovascular diseases (10%).


The MAGIC study will yield important findings with regard to the prevalence and incidence of gastrointestinal complications and related risk factors for low-dose aspirin users. It may also report that use of anti-secretory agents such as proton pump inhibitors reduces the risk of such complications.

Key words

Low-dose aspirin Gastrointestinal complications Coronary artery diseases Cerebrovascular diseases Cohort studies 


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Hideki Origasa
    • 1
  • Shinya Goto
    • 2
  • Kazuyuki Shimada
    • 3
  • Shinichiro Uchiyama
    • 4
  • Yasushi Okada
    • 5
  • Kentaro Sugano
    • 6
  • Hideyuki Hiraishi
    • 7
  • Naomi Uemura
    • 8
  • Yasuo Ikeda
    • 9
  • on behalf of the MAGIC Investigators
  1. 1.Division of Biostatistics and Clinical EpidemiologyUniversity of ToyamaToyamaJapan
  2. 2.Department of Internal MedicineTokai University, IseharaTokyoJapan
  3. 3.Department of CardiologyJichi Medical UniversityShimotsukeJapan
  4. 4.Department of NeurologyTokyo Women’s Medical UniversityTokyoJapan
  5. 5.Department of Cerebrovascular DiseaseKyushu Medical CenterFukuokaJapan
  6. 6.Department of GastroenterologyJichi Medical UniversityShimotsukeJapan
  7. 7.Department of GastroenterologyDokkyo Medical UniversityUtunomiyaJapan
  8. 8.Department of GastroenterologyInternational Medical Center of JapanTokyoJapan
  9. 9.Faculty of Science and EngineeringWaseda UniversityTokyoJapan

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