Farrell B, Godwin J, Richards S, Warlow C
J Neurol Neurosurg Psychiatry. 1991 Dec;54(12):1044-54. doi: 10.1136/jnnp.54.12.1044.
From 1979-85, 2435 patients with a transient ischaemic attack or minor ischaemic stroke were randomly allocated to receive long term "blind" treatment with aspirin 600 mg twice daily (n = 815), aspirin 300 mg once daily (n = 806) or placebo (n = 814). No patient was lost to follow up. The "intention to treat" comparison included all the serious vascular events and deaths which occurred before the end of the follow up period on 30 September 1986. There was no difference in efficacy between the 300 mg and 1200 mg daily doses of aspirin, but the lower dose was undoubtedly less gastrotoxic. Also, there was no definite difference in the response of males and females to aspirin. The odds of suffering a major stroke, myocardial infarction or vascular death were 15% less in the combined aspirin groups compared with the placebo group (95% confidence interval 29% reduction to 3% increase in odds) which is compatible with the continuing overview of all the similar trials of antiplatelet drugs where the relative reduction in odds was 25%. There was no statistically significant reduction in the likelihood of either disabling major stroke and vascular death or vascular death occurring.
1979年至1985年期间,2435例短暂性脑缺血发作或轻度缺血性卒中患者被随机分配接受长期“盲法”治疗,分别为每日两次服用600毫克阿司匹林(n = 815)、每日一次服用300毫克阿司匹林(n = 806)或安慰剂(n = 814)。无患者失访。“意向性治疗”比较纳入了在1986年9月30日随访期结束前发生的所有严重血管事件和死亡病例。每日300毫克和1200毫克剂量的阿司匹林在疗效上无差异,但较低剂量的胃肠道毒性无疑较小。此外,男性和女性对阿司匹林的反应也没有明显差异。与安慰剂组相比,联合阿司匹林组发生严重卒中、心肌梗死或血管死亡的几率低15%(95%置信区间为几率降低29%至增加3%),这与所有抗血小板药物类似试验的持续综述结果相符,即几率相对降低25%。在致残性严重卒中和血管死亡或血管死亡发生的可能性方面,没有统计学上的显著降低。