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针对初级预防的阿司匹林处方干预措施:系统性审查和建议的处方指南
Alison Lobkovich1,2, Hannah Ferrari1,2, Amber Lanae Martirosov1,2
1Department of Pharmacy, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA.
Pharmacotherapy
|February 19, 2026
概括
阿司匹林用于动脉样硬化心血管疾病 (ASCVD) 的初级预防具有可疑的益处与风险. 本综述探讨了阿司匹林停止处方的策略,并提出了一种指导初级预防患者停止治疗的算法.
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.
- 基于证据的医学 基于证据的医学
背景情况:
- 最近的文献表明,与风险相比,阿司匹林对动脉样硬化心血管疾病 (ASCVD) 的初级预防益处是不确定的.
- 对阿司匹林使用的临床实践指南已经缩小了范围,但缺乏对抑郁症的指导.
研究的目的:
- 为初级ASCVD预防系统地审查阿司匹林下药的策略.
- 提出一种实用的算法,用于在与当前建议不一致的患者下降阿司匹林的处方.
主要方法:
- 从2018年1月到2025年3月,在主要数据库 (EMBASE,PubMed,科学网,Scopus,CINAHL) 进行系统的文献搜索.
- 选了167项研究,其中包括13篇文章用于分析.
- 对旨在降低阿司匹林处方的各种干预措施的审查.
主要成果:
- 包括的研究使用提示来触发抑郁症,但没有确定一致的方法.
- 在50%的研究中,多学科模型产生了最高的抑郁症率 (78%).
- 有限的数据存在于阿司匹林下药后患者相关的结果.
结论:
- 对于用于ASCVD初级预防的阿司匹林减缓处方需要进一步调查.
- 抑郁的算法可以帮助指导个性化的阿司匹林停用,考虑到患者的偏好.
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