Department of Medicine, University of Virginia , Charlottesville, VA, USA.
Department of Medicine, University of Rochester School of Medicine , Rochester, NY, USA.
Platelets. 2021 Jan 2;32(1):138-140. doi: 10.1080/09537104.2020.1732329. Epub 2020 Mar 6.
Venous thromboembolism (VTE) whether provoked or not can be life-threatening due to an acute increase in load on the right ventricle (RV) from obstruction of the pulmonary artery (PA). Treatment for and prevention of VTE involves anti-thrombotic agents; more specifically, medications targeting the anticoagulation cascade. In spite of the widespread acceptance of anticoagulants in the treatment of VTE, there appears to be an ongoing belief that platelet reactivity contributes to thrombus burden in patients with acute pulmonary embolism (PE). This investigation of 398 patients presenting with acute PE evaluated whether anti-platelet medication use, which consisted mostly of aspirin therapy, at the time of presentation, affects PA thrombus burden, RV load, or short-term patient outcomes. We conclude that platelets may have been erroneously incriminated as direct thrombotic mediators in patients with acute PE since aspirin neither decreased PA thrombus burden, nor did aspirin improve short-term mortality following acute PE.
静脉血栓栓塞症（VTE）无论是由何种原因引起的，都可能因肺动脉（PA）阻塞导致右心室（RV）负荷急剧增加而危及生命。VTE 的治疗和预防涉及抗血栓药物；更具体地说，是针对抗凝级联反应的药物。尽管抗凝剂在 VTE 的治疗中得到广泛认可，但似乎仍有人认为血小板反应性会增加急性肺栓塞（PE）患者的血栓负担。本研究纳入了 398 名急性 PE 患者，评估了在就诊时使用抗血小板药物（主要是阿司匹林治疗）是否会影响 PA 血栓负担、RV 负荷或短期患者结局。我们得出的结论是，血小板可能被错误地归咎为急性 PE 患者的直接促血栓介质，因为阿司匹林既没有降低 PA 血栓负担，也没有改善急性 PE 后的短期死亡率。
