Minneapolis Heart Institute Foundation, Minneapolis Heart Institute, Minneapolis, Minnesota, USA.
Curr Opin Cardiol. 2019 Sep;34(5):510-513. doi: 10.1097/HCO.0000000000000648.
Aspirin has been used for decades for the primary prevention of cardiovascular disease. However, several recent trials evaluating the benefits and risks of aspirin for primary prevention have been published, creating the need to reevaluate this important topic.
Three large randomized trials studying aspirin in various primary prevention populations including individuals with diabetes, an elderly population, and middle-aged adults at high cardiovascular risk have recently been completed. These trials found a small benefit for individuals with diabetes and no benefit in the elderly and high risk middle-aged adult populations. Additionally, all three trials demonstrated a clear increase in risk for bleeding events.
The recent trials confirm that, in modern primary prevention populations, the cardiovascular benefit of aspirin is small and comes with a clear increase in risk for bleeding. For the majority of adults without established cardiovascular disease, the risk of a daily aspirin outweighs the benefit.
阿司匹林已被用于数十年的心血管疾病一级预防。然而，最近发表了几项评估阿司匹林用于一级预防的益处和风险的临床试验，这需要重新评估这一重要课题。
最近完成了三项大型随机试验，研究了阿司匹林在各种一级预防人群中的应用，包括糖尿病患者、老年人群和心血管高危的中年人群。这些试验发现阿司匹林对糖尿病患者有一定益处，但对老年人和高危中年人群则没有益处。此外，这三项试验都表明出血事件的风险明显增加。
最近的试验证实，在现代一级预防人群中，阿司匹林的心血管益处较小，且出血风险明显增加。对于大多数没有明确心血管疾病的成年人来说，每日服用阿司匹林的风险大于益处。
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