心血管疾患の予防のためのアスピリン用量:体系的なレビュー
Charles L Campbell1, Susan Smyth, Gilles Montalescot
1Gill Heart Institute, University of Kentucky, Lexington, USA. clcampbell@uky.edu
JAMA
|May 10, 2007
まとめ
心血管疾患の長期的な予防のために,低用量アスピリン (75-81 mg/d) は高用量よりも効果的で安全です. アスピリンの高用量は有効性を向上させず,胃腸出血のリスクを高めます.
科学分野:
- 心臓病学 心臓病学
- 薬理学 薬理学とは
- 予防医学は,予防的な医療です.
背景:
- 5千万人以上の米国成人は,心血管疾患 (CVD) の予防のためにアスピリンを使用しています.
- 一般的に処方されるアスピリンの用量は,81 mg/dと325 mg/dです.
- CVDの予防のための最適な長期アスピリン用量は,依然として議論されている.
研究 の 目的:
- アスピリンの作用メカニズムを見直す.
- アスピリンの投与量,有効性,およびCVD予防における安全性に関する臨床文献を分析する.
主な方法:
- 英語文学の体系的なレビュー (MEDLINE,EMBASE 2007年2月まで).
- アスピリン投与量とCVDに関する臨床試験と前向きな研究が含まれています.
- 検索条件:アスピリン,アセチルサリチル酸,量.
主要な成果:
- 低用量アスピリン (≥30 mg/d) は,血小板血栓素の生成を完全に抑制する.
- アスピリンの75-81 mg/dは,二次性CVD予防のためにより高い用量と同じくらい効果的です.
- アスピリンの高用量 (例えば325 mg/d) は,胃腸出血のリスクを高めます.
結論:
- 現在のデータは,CVDの予防のために75~81mg/日以上のアスピリンの常用長期使用を支持していません.
- より高いアスピリンの用量は,追加の有効性を提供しませんが,出血のリスクを高めます.
- 低用量アスピリン (75-81 mg/d) は,長期的なCVD予防のために推奨されます.
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