Lou Guozhong, Chen Jianming, Xia Yu
Department of Cardiology, Zhejiang Hospital, Zhejiang, China.
Cardiovascular Center, Qingyuan Hospital of Traditional Chinese Medicine, Affiliated Hospital of Traditional Chinese Medicine University of Guangzhou, No.10, Qiaobei Road, Qingchen District, Qingyuan, Guangdong Province, 511000, China.
Lipids Health Dis. 2016 Jun 16;15:106. doi: 10.1186/s12944-016-0274-8.
To evaluate the efficacy and safety of aspirin usage for coronary heart disease (CHD) primary prevention in patients with dyslipidemia.
A cross-sectional study was conducted to enrolled subjects with documented dyslipidemia. A total of 202 patients with dyslipidemia were recruited and 138 were undergone aspirin treatment before this indexed admission and 64 had never been treated with aspirin. All subjects were undergone coronary angiography to diagnoses CHD. Clinical characteristics were collected and comparisons were performed between subjects with aspirin and subjects without aspirin therapy. Logistic regression analysis was conducted to assess the relation between aspirin and incident CHD and bleeding events.
Compared to those with aspirin therapy, CHD incidence was significantly higher in subjects without aspirin therapy (23.4 % versus 18.1 %, P < 0.05). Five patients in the aspirin group had gastrointestinal bleeding and no bleeding event was occurred in subjects without aspirin therapy. Subjects with aspirin therapy had higher rate of previous helicobacter pylori (HP) infection (8.7 % versus 4.7 %, P < 0.05). Compared to subjects without CHD, subjects with CHD were older, had higher frequencies of males and smokers, had higher heart rate, serum LDL cholesterol, Lp(a) and Hs-CRP levels. Percentages of subjects with hypertension, diabetes, gastrointestinal bleeding, and HP infection were also considerably higher in CHD group (P < 0.05 for all comparison). Logistic regression analysis revealed that aspirin was associated with reduced incidence of CHD, with odds ratio (OR) of 0.85 (95 % confidence interval (CI): 0.80-0.94, P < 0.05). Regarding safety endpoint, gastrointestinal bleeding risk associated with aspirin was attenuated to nonsignificant after adjusting for HP infection, with OR of 1.16 (95 % CI: 0.99-1.52, P = 0.178).
Aspirin is beneficial for reducing incident CHD, while modestly increases gastrointestinal bleeding risk. Screening subjects with previous HP infection may avoid aspirin-related gastrointestinal bleeding.
评估阿司匹林用于血脂异常患者冠心病（CHD）一级预防的疗效和安全性。
进行一项横断面研究，纳入有血脂异常记录的受试者。共招募了202例血脂异常患者，其中138例在本次索引入院前接受了阿司匹林治疗，64例从未接受过阿司匹林治疗。所有受试者均接受冠状动脉造影以诊断冠心病。收集临床特征，并在接受阿司匹林治疗的受试者和未接受阿司匹林治疗的受试者之间进行比较。进行逻辑回归分析以评估阿司匹林与冠心病发病及出血事件之间的关系。
与接受阿司匹林治疗的受试者相比，未接受阿司匹林治疗的受试者冠心病发病率显著更高（23.4%对18.1%，P<0.05）。阿司匹林组有5例患者发生胃肠道出血，未接受阿司匹林治疗的受试者未发生出血事件。接受阿司匹林治疗的受试者既往幽门螺杆菌（HP）感染率更高（8.7%对4.7%，P<0.05）。与无冠心病的受试者相比，有冠心病的受试者年龄更大，男性和吸烟者的比例更高，心率、血清低密度脂蛋白胆固醇、脂蛋白（a）和超敏C反应蛋白水平更高。冠心病组中高血压、糖尿病、胃肠道出血和HP感染受试者的百分比也显著更高（所有比较P<0.05）。逻辑回归分析显示，阿司匹林与冠心病发病率降低相关，比值比（OR）为0.85（95%置信区间（CI）：0.80 - 0.94，P<0.05）。关于安全性终点，在调整HP感染后，与阿司匹林相关的胃肠道出血风险减弱至无统计学意义，OR为1.16（95%CI：0.99 - 1.52，P = 0.178）。
阿司匹林有利于降低冠心病发病风险，但会适度增加胃肠道出血风险。筛查既往有HP感染的受试者可避免阿司匹林相关的胃肠道出血。
