抗血小板治疗,腹腔大动脉动脉瘤进展和临床结果
Essa Hariri1,2, Milad Matta3,4, Habib Layoun1,5
1Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio.
JAMA network open
|December 12, 2023
概括
腹腔大动脉动脉瘤 (AAA) 患者使用阿司匹林与动脉瘤生长速度减缓有关. 这项研究没有发现AAA患者与阿司匹林相关的死亡或重大出血风险增加.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 临床前研究表明,阿司匹林可能会减缓腹腔大动脉瘤 (AAA) 的进展,并防止破裂.
- 目前支持阿司匹林在人类AAA病例中的益处的临床证据有限.
研究的目的:
- 检查阿司匹林使用与AAA患者动脉瘤进展之间的关联.
- 在AAA患者中调查与阿司匹林使用相关的长期临床结果.
主要方法:
- 回顾性,单中心队列研究,包括3435名成年患者,至少两次血管超声波.
- 排除标准包括先前的动脉瘤修复,剖析或破裂;10年的随访.
- 统计分析涉及临床结果的Cox比例危险回归和竞争风险回归,以及动脉瘤进展的线性/逻辑回归.
主要成果:
- 服用阿司匹林的患者 (63%的队列) 呈现较慢的年平均动脉瘤直径变化 (2.8比3.8毫米/年,P=.001).
- 服用阿司匹林的人患动脉瘤迅速进展的几率较低 (调整后的几率比,0.64;P=.002).
- 服用阿司匹林并没有显著增加任何原因死亡率,严重出血或10年后剖析,破裂和修复的复合结果的风险.
结论:
- 在3435名患者的队列中,阿司匹林使用与腹部大动脉动脉瘤进展的减缓有显著关联.
- 该研究表明,阿司匹林在这个患者群体中的使用具有有利的安全性.
- 研究结果表明阿司匹林在控制AAA生长方面可能发挥作用.
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