阿司匹林作为初级预防中的抗血小板治疗作用。最新进展。

The role of aspirin as antiaggregant therapy in primary prevention. An update.

机构信息

Servicio de Medicina Interna, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España.

出版信息

Med Clin (Barc). 2019 Oct 25;153(8):326-331. doi: 10.1016/j.medcli.2019.05.024. Epub 2019 Sep 11.

DOI:10.1016/j.medcli.2019.05.024

Abstract

Aspirin indication in primary prevention has been questioned in the last ten years due to the publication of several trials with neutral outcomes. In the last year, three research studies discussed in this review (ASCEND, ARRIVE, ASPREE) have weighed the benefit (cardiovascular events reduction) against the adverse effects (especially bleeding) in several situations such as general population with moderate cardiovascular risk, diabetics and elderly population. This review performs a detailed analysis of these trials and it also comments on a recent metanalysis that includes these projects along with others undertaken in the last 30 years. In addition, the current position of aspirin in primary prevention is established based on the latest evidence reviewed.

摘要

由于几项结果为中性的试验的发表，阿司匹林在一级预防中的适应证在过去十年中受到了质疑。在过去的一年中，本综述中讨论的三项研究（ASCEND、ARRIVE、ASPREE）在多种情况下权衡了获益（心血管事件减少）与不良反应（特别是出血），例如中等心血管风险的一般人群、糖尿病患者和老年人群。本综述对这些试验进行了详细分析，并对最近的一项荟萃分析进行了评论，该分析包括了这些项目以及过去 30 年中开展的其他项目。此外，根据最新的综述证据，确定了阿司匹林在一级预防中的当前地位。