Mekaj Ymer H, Daci Fetije T, Mekaj Agon Y
Institute of Pathophysiology, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo ; Department of Hemostasis and Thrombosis, National Blood Transfusion Center of Kosovo, University of Prishtina, Prishtina, Kosovo.
Department of Hemostasis and Thrombosis, National Blood Transfusion Center of Kosovo, University of Prishtina, Prishtina, Kosovo.
Ther Clin Risk Manag. 2015 Sep 24;11:1449-56. doi: 10.2147/TCRM.S92222. eCollection 2015.
The antithrombotic action of aspirin has long been recognized. Aspirin inhibits platelet function through irreversible inhibition of cyclooxygenase (COX) activity. Until recently, aspirin has been mainly used for primary and secondary prevention of arterial antithrombotic events. The aim of this study was to review the literature with regard to the various mechanisms of the newly discovered effects of aspirin in the prevention of the initiation and development of venous thrombosis. For this purpose, we used relevant data from the latest numerous scientific studies, including review articles, original research articles, double-blinded randomized controlled trials, a prospective combined analysis, a meta-analysis of randomized trials, evidence-based clinical practice guidelines, and multicenter studies. Aspirin is used in the prevention of venous thromboembolism (VTE), especially the prevention of recurrent VTE in patients with unprovoked VTE who were treated with vitamin K antagonists (VKAs) or with non-vitamin K antagonist oral anticoagulants (NOACs). Numerous studies have shown that aspirin reduces the rate of recurrent VTE in patients, following cessation of VKAs or NOACs. Furthermore, low doses of aspirin are suitable for long-term therapy in patients recovering from orthopedic or other surgeries. Aspirin is indicated for the primary and secondary prevention as well as the treatment of cardiovascular diseases, including acute coronary syndrome, myocardial infarction, peripheral artery disease, acute ischemic stroke, and transient ischemic attack (especially in atrial fibrillation or mechanical heart valves). Aspirin can prevent or treat recurrent unprovoked VTEs as well as VTEs occurring after various surgeries or in patients with malignant disease. Recent trials have suggested that the long-term use of low-dose aspirin is effective not only in the prevention and treatment of arterial thrombosis but also in the prevention and treatment of VTE. Compared with VKAs and NOACs, aspirin has a reduced risk of bleeding.
阿司匹林的抗血栓作用早已为人所知。阿司匹林通过不可逆地抑制环氧化酶（COX）活性来抑制血小板功能。直到最近，阿司匹林主要用于动脉抗血栓事件的一级和二级预防。本研究的目的是回顾有关阿司匹林在预防静脉血栓形成的起始和发展方面新发现作用的各种机制的文献。为此，我们使用了来自众多最新科学研究的相关数据，包括综述文章、原创研究文章、双盲随机对照试验、前瞻性综合分析、随机试验的荟萃分析、循证临床实践指南和多中心研究。阿司匹林用于预防静脉血栓栓塞（VTE），特别是预防接受维生素K拮抗剂（VKAs）或非维生素K拮抗剂口服抗凝剂（NOACs）治疗的不明原因VTE患者的复发性VTE。大量研究表明，阿司匹林可降低停用VKAs或NOACs后患者复发性VTE的发生率。此外，低剂量阿司匹林适用于骨科或其他手术后康复患者的长期治疗。阿司匹林适用于心血管疾病的一级和二级预防以及治疗，包括急性冠状动脉综合征、心肌梗死、外周动脉疾病、急性缺血性中风和短暂性脑缺血发作（特别是在心房颤动或机械心脏瓣膜患者中）。阿司匹林可预防或治疗复发性不明原因VTE以及各种手术后或恶性疾病患者发生的VTE。最近的试验表明，长期使用低剂量阿司匹林不仅在预防和治疗动脉血栓形成方面有效，而且在预防和治疗VTE方面也有效。与VKAs和NOACs相比，阿司匹林的出血风险更低。
