Kim Joonseok, Becker Richard C
Division of Cardiovascular Health and Disease, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45257, USA.
J Thromb Thrombolysis. 2016 Apr;41(3):493-504. doi: 10.1007/s11239-015-1307-2.
Aspirin has been a cornerstone of cardiovascular disease prevention since the late 1980s. Despite the popularity of aspirin and its wide use, the proper dosing and frequency of aspirin has yet to be determined. Early aspirin trials focused on its utility in broad target populations, but this strategy did not magnify the benefit of aspirin, and rather increased the complication rate. We have learned from previous studies that laboratory and clinical response to aspirin therapy in patients with different conditions and settings are diverse. This difference in aspirin response necessitates a personalized, tailored aspirin therapy. We aim to perform a comprehensive review of the current evidence surrounding aspirin responsiveness in several distinct patient populations and the rationale of different aspirin frequency and dosing strategies. Our conclusions call for future studies to determine individualized aspirin strategies to maximize the benefit and minimize the risk of aspirin.
自20世纪80年代末以来,阿司匹林一直是心血管疾病预防的基石。尽管阿司匹林广受欢迎且使用广泛,但其合适的剂量和服用频率尚未确定。早期的阿司匹林试验侧重于其在广泛目标人群中的效用,但这种策略并未放大阿司匹林的益处,反而增加了并发症发生率。我们从先前的研究中了解到,不同病情和环境的患者对阿司匹林治疗的实验室和临床反应各不相同。阿司匹林反应的这种差异需要个性化、量身定制的阿司匹林治疗。我们旨在对当前围绕几种不同患者群体中阿司匹林反应性的证据以及不同阿司匹林频率和给药策略的基本原理进行全面综述。我们的结论呼吁未来开展研究,以确定个体化的阿司匹林策略,从而使阿司匹林的益处最大化并将风险降至最低。