Maestrini Ilaria, Altieri Marta, Di Clemente Laura, Vicenzini Edoardo, Pantano Patrizia, Raz Eytan, Silvestrini Mauro, Provinciali Leandro, Paolino Isabella, Marini Carmine, Di Giuseppe Matteo, Russo Tommasina, Federico Francesco, Coppola Cristiana, Prontera Maria Pia, Mezzapesa Domenico Maria, Lucivero Vincenzo, Parnetti Lucilla, Sarchielli Paola, Peducci Maria, Inzitari Domenico, Carlucci Giovanna, Serrati Carlo, Zat Carla, Cavallini Anna, Persico Alessandra, Micieli Giuseppe, Bastianello Stefano, Di Piero Vittorio
Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy.
IRCSS Neuromed, Pozzilli (IS), Italy.
Stroke Res Treat. 2018 Oct 3;2018:7532403. doi: 10.1155/2018/7532403. eCollection 2018.
We investigated low-dose aspirin (ASA) efficacy and safety in subjects with silent brain infarcts (SBIs) in preventing new cerebrovascular (CVD) events as well as cognitive impairment.
We included subjects aged ≥45 years, with at least one SBI and no previous CVD. Subjects were followed up to 4 years assessing CVD and SBI incidence as primary endpoint and as secondary endpoints: (a) cardiovascular and adverse events and (b) cognitive impairment.
Thirty-six subjects received ASA while 47 were untreated. Primary endpoint occurred in 9 controls (19.1%) versus 2 (5.6%) in the ASA group (p=0.10). Secondary endpoints did not differ in the two groups. Only baseline leukoaraiosis predicts primary [OR 5.4 (95%CI 1.3-22.9, p=0.022)] and secondary endpoint-a [3.2 (95%CI 1.1-9.6, p=0.040)] occurrence.
These data show an increase of new CVD events in the untreated group. Despite the study limitations, SBI seems to be a negative prognostic factor and ASA preventive treatment might improve SBI prognosis. is registered with EudraCT Number: 2005-000996-16; Sponsor Protocol Number: 694/30.06.04.
我们研究了低剂量阿司匹林（ASA）在无症状脑梗死（SBI）患者中预防新发脑血管（CVD）事件以及认知障碍的疗效和安全性。
我们纳入了年龄≥45岁、至少有一处SBI且既往无CVD的患者。对患者进行了长达4年的随访，评估CVD和SBI的发生率作为主要终点，以及以下次要终点：（a）心血管和不良事件；（b）认知障碍。
36名患者接受了ASA治疗，47名患者未接受治疗。主要终点在9名对照组患者中发生（19.1%），而ASA组为2名（5.6%）（p = 0.10）。两组的次要终点无差异。只有基线脑白质疏松症可预测主要终点[比值比5.4（95%置信区间1.3 - 22.9，p = 0.022）]和次要终点-a[3.2（95%置信区间1.1 - 9.6，p = 0.040）]的发生。
这些数据显示未治疗组中新发CVD事件有所增加。尽管存在研究局限性，但SBI似乎是一个不良预后因素，ASA预防性治疗可能会改善SBI的预后。该研究已在欧洲临床试验数据库（EudraCT）注册，编号：2005 - 000996 - 16；申办者方案编号：694/30.06.04。
