Gaglia Michael A, Clavijo Leonardo
1Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
J Cardiovasc Pharmacol Ther. 2013 Nov;18(6):505-13. doi: 10.1177/1074248413503043. Epub 2013 Sep 19.
Acetylsalicylic acid, or aspirin, is perhaps the most well-studied drug in human history, but controversy persists regarding both optimal dose and its use in the primary prevention of atherothrombotic events. This article reviews the following: the effect of aspirin upon the cyclooxygenase pathway; clinical trials of aspirin for both secondary and primary prevention; prospective and retrospective studies of aspirin dose; the potential interaction between aspirin and ticagrelor; and the concept of aspirin resistance. It concludes with a review of major society guidelines regarding aspirin and offers a perspective on the evidence-based use of aspirin in clinical practice.
乙酰水杨酸,即阿司匹林,或许是人类历史上研究最为深入的药物,但在最佳剂量及其在动脉粥样血栓形成事件一级预防中的应用方面,争议仍然存在。本文回顾了以下内容:阿司匹林对环氧化酶途径的影响;阿司匹林用于二级预防和一级预防的临床试验;阿司匹林剂量的前瞻性和回顾性研究;阿司匹林与替格瑞洛之间的潜在相互作用;以及阿司匹林抵抗的概念。文章最后对主要学会关于阿司匹林的指南进行了综述,并就阿司匹林在临床实践中的循证使用提出了观点。