Michel P L
Service de Cardiologie, Hôpital Tenon, Paris.
Ann Cardiol Angeiol (Paris). 1994 Apr;43(4):204-10.
Thrombotic occlusion is one of the chief complications of coronary atherosclerosis. The search for an effective method to prevent coronary thrombosis has thus been an active research area for several years. The anti-thrombotic drug most studied during the past twenty years has been aspirin. Many studies have shown the usefulness of aspirin in the secondary prevention of recurrences of cardiovascular disease: during the acute phase of myocardial infarction, post-infarction, in unstable angina, and following angioplasty or aortocoronary bypass. While the benefits of this platelet anti-aggregant are now unanimously recognised, since aspirin reduces by approximately 25% the risk of a further coronary event after a first episode, the question today concerns the optimal dose to be used in each pathological context. Analysis of data from major clinical trials of aspirin as secondary prevention reveals the usefulness of a daily dose of aspirin of between 160 and 300 mg, with many studies undertaken at the dose of 300 mg/day. In the special case of the acute phase of myocardial infarction, the dose of 160 mg/day appears most suitable, as shown by the results of the vast ISIS II study.
血栓形成性闭塞是冠状动脉粥样硬化的主要并发症之一。因此，寻找一种预防冠状动脉血栓形成的有效方法，多年来一直是一个活跃的研究领域。在过去二十年中研究最多的抗血栓药物是阿司匹林。许多研究表明，阿司匹林在心血管疾病复发的二级预防中有用：在心肌梗死急性期、心肌梗死后、不稳定型心绞痛以及血管成形术或主动脉冠状动脉搭桥术后。虽然这种血小板聚集抑制剂的益处现在已得到一致认可，因为阿司匹林可将首次发作后再次发生冠状动脉事件的风险降低约25%，但如今的问题是在每种病理情况下应使用的最佳剂量。对阿司匹林作为二级预防的主要临床试验数据的分析表明，每日服用160至300毫克阿司匹林是有用的，许多研究是在300毫克/天的剂量下进行的。在心肌梗死急性期的特殊情况下，如大规模ISIS II研究结果所示，160毫克/天的剂量似乎最合适。
