Battistoni Allegra, Mastromarino Vittoria, Volpe Massimo
Cardiology Department, Clinical and Molecular Medicine Department, Sapienza University of Rome, Rome, Italy.
IRCCS Neuromed (Volpe), Pozzilli, Italy.
Clin Cardiol. 2015 Jun;38(6):387-94. doi: 10.1002/clc.22394. Epub 2015 Apr 14.
Emerging evidence suggesting the possibility that interventions able to prevent cardiovascular disease (CVD) may also be effective in the prevention of cancer have recently stimulated great interest in the medical community. In particular, data from both experimental and observational studies have demonstrated that aspirin may play a role in preventing different types of cancer. Although the use of aspirin in the secondary prevention of CVD is well established, aspirin in primary prevention is not systematically recommended because the absolute cardiovascular event reduction is similar to the absolute excess in major bleedings. By adding to its cardiovascular prevention benefits, the potential beneficial effect of aspirin in reducing the incidence of mortality and cancer could tip the balance between risks and benefits of aspirin therapy in primary prevention in favor of the latter and broaden the indication for treatment with aspirin in populations at average risk. Prospective and randomized studies are currently investigating the effect of aspirin in prevention of both cancer and CVD; however, clinical efforts at the individual level to promote the use of aspirin in global (or total) primary prevention already could be made on the basis of a balanced evaluation of the benefit/risk ratio.
新出现的证据表明，能够预防心血管疾病（CVD）的干预措施可能对预防癌症也有效，这一可能性最近在医学界引起了极大关注。特别是，来自实验和观察性研究的数据都表明，阿司匹林可能在预防不同类型的癌症中发挥作用。虽然阿司匹林在心血管疾病二级预防中的应用已得到充分确立，但阿司匹林在一级预防中并未得到系统推荐，因为心血管事件绝对减少量与主要出血的绝对过量相似。除了其心血管预防益处外，阿司匹林在降低死亡率和癌症发病率方面的潜在有益作用可能会使阿司匹林一级预防治疗的风险与益处之间的平衡倾向于后者，并扩大阿司匹林在平均风险人群中的治疗适应症。前瞻性和随机研究目前正在调查阿司匹林在预防癌症和心血管疾病方面的作用；然而，基于对获益/风险比的平衡评估，在个体层面上已经可以在全球（或总体）一级预防中推动使用阿司匹林的临床努力。
