Cicci Jonathan D, Iyer Prashanth, Clarke Megan M, Mazzella Anthony J
From the Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC.
Division of Cardiology, Department of Medicine, University of North Carolina Hospitals, Chapel Hill, NC.
Cardiol Rev. 2020 Mar/Apr;28(2):98-106. doi: 10.1097/CRD.0000000000000297.
Cardiovascular disease is the leading cause of death globally, and deaths due to coronary heart disease or stroke account for over half of all cardiovascular deaths in the United States. While many important advances have been made in the treatment and secondary prevention of atherosclerotic cardiovascular disease (ASCVD), morbidity and mortality remain high. Aspirin has been commonly used for the primary and secondary prevention of ASCVD for decades and is an easily accessible therapeutic option. While it is a cornerstone of secondary prevention, its role in primary prevention is less clear and professional guidelines have differed in their recommendations. As literature has substantially evolved over the past 40 years, so too has our understanding of aspirin's role in the primary prevention of ASCVD. This article reviews landmark clinical trials of aspirin in primary prevention and highlights key changes in dosing strategies and demographics.
心血管疾病是全球主要的死亡原因，在美国，冠心病或中风导致的死亡占所有心血管疾病死亡的一半以上。虽然在动脉粥样硬化性心血管疾病（ASCVD）的治疗和二级预防方面已经取得了许多重要进展，但发病率和死亡率仍然很高。几十年来，阿司匹林一直被广泛用于ASCVD的一级和二级预防，是一种易于获得的治疗选择。虽然它是二级预防的基石，但其在一级预防中的作用尚不清楚，专业指南的建议也不尽相同。随着过去40年文献的不断发展，我们对阿司匹林在ASCVD一级预防中的作用的理解也在不断变化。本文回顾了阿司匹林在一级预防中的里程碑式临床试验，并强调了给药策略和人群特征的关键变化。
