Dale J, Myhre E
Acta Med Scand Suppl. 1981;645:73-8. doi: 10.1111/j.0954-6820.1981.tb02603.x.
Encouraged by the effective prevention of arterial thromboembolism with a combination of ASA and anticoagulants (9), the present study was done in 77 patients with a single Starr-Edwards aortic ball valve. They received one gm. of ASA daily, then the dose of anticoagulants was reduced gradually and the drug discontinued on average five weeks later. Six arterial embolic episodes occurred in five patients, the incidence being 14.5 complications per 100 patients per year. Five emboli were cerebral, none of them serious, and one was removed from a femoral artery. Four of the embolic episodes occurred in three of the 11 patients with continuous arrhythmia, probably from venus thrombi that developed in the left atrium. The occurrence of only two embolic complications in the 66 patients with sinus rhythm suggests some prevention of arterial thrombus formation on the prosthetic valves. The results indicate that ASA is inferior to anticoagulants in patients with arrhythmia, while it may represent an alternative to anticoagulation in individuals with sinus rhythm. We prefer, however, the combined therapy in patients with aortic valve prostheses because of the strong anti-thrombotic effect achieved by this treatment.
受阿司匹林（ASA）与抗凝剂联合使用有效预防动脉血栓栓塞的鼓舞（9），本研究对77例植入单个斯塔尔-爱德华兹主动脉球瓣的患者进行。他们每天服用1克ASA，然后逐渐减少抗凝剂剂量，平均五周后停药。5例患者发生了6次动脉栓塞事件，发生率为每100例患者每年14.5次并发症。5次栓塞发生在脑部，均不严重，1次从股动脉取出。11例持续心律失常患者中有3例发生了4次栓塞事件，可能源于左心房形成的静脉血栓。66例窦性心律患者仅发生2次栓塞并发症，提示人工瓣膜上的动脉血栓形成得到了一定预防。结果表明，ASA在心律失常患者中不如抗凝剂有效，而在窦性心律患者中它可能是抗凝治疗的一种替代方法。然而，由于这种联合治疗具有强大的抗血栓作用，我们更倾向于对主动脉瓣人工瓣膜患者采用联合治疗。
