Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA; email:
Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Annu Rev Med. 2021 Jan 27;72:473-495. doi: 10.1146/annurev-med-051019-102940.
More than a century after its synthesis, daily aspirin, given at a low dose, is a milestone treatment for the secondary prevention of cardiovascular disease (CVD). Its role in primary prevention of CVD is still debated. Older randomized controlled trials showed that aspirin reduced the low incidence of myocardial infarction but correspondingly increased the low incidence of serious gastrointestinal bleeds without altering mortality. More recent trials see the benefit attenuated, perhaps obscured by other cardioprotective practices, while the bleeding risk remains, especially in older patients. Indirect evidence, both preclinical and clinical, suggests that aspirin may protect against sporadic colorectal cancer and perhaps other cancers. However, further studies are still necessary to warrant the consumption of aspirin for primary prevention of CVD and cancer by apparently healthy individuals.
在其合成一个多世纪后，每天低剂量服用阿司匹林是心血管疾病（CVD）二级预防的里程碑式治疗方法。但其在 CVD 一级预防中的作用仍存在争议。较早期的随机对照试验表明，阿司匹林可降低心肌梗死的低发生率，但相应地增加了严重胃肠道出血的低发生率，而不改变死亡率。最近的试验表明，这种益处减弱了，也许被其他心脏保护措施所掩盖，而出血风险仍然存在，尤其是在老年患者中。临床前和临床的间接证据表明，阿司匹林可能有助于预防散发性结直肠癌和其他一些癌症。然而，仍需要进一步的研究来证明阿司匹林对明显健康的个体用于 CVD 和癌症的一级预防是合理的。
