Gowda Smitha Narayana, Bell Matthew, Jahraus Matthew, Fanciullo Joseph
University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
S D Med. 2020 Mar;73(3):130-135.
Aspirin is one of the most widely used drugs for the treatment of cardiovascular disease. While its use in patients with known cardiovascular disease has been supported with trials which have included mortality benefit, the utility of aspirin therapy in patients without established cardiovascular disease has been less clear. Early trials appeared to demonstrate benefit with the use of aspirin, but trials after 2000 did not consistently substantiate using aspirin for primary prevention of cardiovascular disease. Despite the lack of robust supportive evidence, aspirin was recommended and used extensively for primary prevention in patients at higher risk for cardiovascular events. More recently in 2018, results of three randomized, controlled trials: ARRIVE, ASCEND, ASPREE demonstrated modest to no benefit in preventing cardiovascular events and mortality with aspirin use for primary prevention. These trials also demonstrated an increased risk of bleeding in these patients who were on aspirin for primary prevention.
阿司匹林是治疗心血管疾病最常用的药物之一。虽然已知心血管疾病患者使用阿司匹林已通过包括死亡率获益的试验得到支持，但阿司匹林疗法在无确诊心血管疾病患者中的效用尚不太明确。早期试验似乎表明使用阿司匹林有益，但2000年后的试验并未始终如一地证实使用阿司匹林进行心血管疾病一级预防的有效性。尽管缺乏有力的支持证据，但阿司匹林仍被推荐并广泛用于心血管事件高危患者的一级预防。最近在2018年，三项随机对照试验（ARRIVE、ASCEND、ASPREE）的结果表明，使用阿司匹林进行一级预防在预防心血管事件和死亡率方面获益不大或无获益。这些试验还表明，这些接受阿司匹林一级预防的患者出血风险增加。
