预防心血管疾病的阿司匹林剂量:系统性审查
Charles L Campbell1, Susan Smyth, Gilles Montalescot
1Gill Heart Institute, University of Kentucky, Lexington, USA. clcampbell@uky.edu
JAMA
|May 10, 2007
概括
对于长期预防心血管疾病,低剂量阿司匹林 (75-81毫克/天) 比高剂量更有效,更安全. 较高的阿司匹林剂量不会提高疗效,但会增加胃肠道出血的风险.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 预防医学 预防医学
背景情况:
- 超过5000万美国成年人使用阿司匹林预防心血管疾病 (CVD).
- 通常处方的阿司匹林剂量为每天81毫克和每天325毫克.
- 预防心血管疾病的最佳长期阿司匹林剂量仍在争论中.
研究的目的:
- 审查阿司匹林的作用机制.
- 分析关于阿司匹林剂量,疗效和预防心血管疾病的安全性的临床文献.
主要方法:
- 英语文学的系统审查 (MEDLINE,EMBASE到2007年2月).
- 包括关于阿司匹林剂量和心血管疾病的临床试验和前性研究.
- 搜索词:阿司匹林,乙盐酸,剂量.
主要成果:
- 低剂量阿司匹林 (≥30 mg/d) 完全抑制了血小板血栓素的产生.
- 75-81毫克/天的阿司匹林在二次心血管疾病预防中与更高剂量一样有效.
- 较高的阿司匹林剂量 (例如325 mg/d) 会增加胃肠道出血的风险.
结论:
- 目前的数据不支持常规长期使用阿司匹林>75-81毫克/天用于预防心血管疾病.
- 较高的阿司匹林剂量没有提供额外的疗效,但会增加出血风险.
- 低剂量阿司匹林 (75-81毫克/天) 建议用于长期预防心血管疾病.
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