N Engl J Med:一文了解阿司匹林对健康老年人心血管事件和出血的影响

2018-09-29 吴星 环球医学网

2018年9月,澳大利亚和美国学者在《N Engl J Med》发表了一项研究,考察了阿司匹林对健康老年人心血管事件和出血的影响。

2018年9月,澳大利亚和美国学者在《N Engl J Med》发表了一项研究,考察了阿司匹林对健康老年人血管事件和出血的影响。

背景:阿司匹林是血管事件二级预防的明确治疗药物。然而,其在心血管疾病一级预防中的作用未知,尤其对于风险增加的老年人。

方法:2010~2014年,研究者纳入了澳大利亚和美国社区管理的老年人(70岁或以上,或≥65岁的美国黑人和西班牙裔美国人),参与者的入组标准为,无心血管疾病、痴呆或身体残疾。参与者被随机分配到每天接受肠溶阿司匹林100 mg或安慰剂的组中。首要终点为死亡、痴呆或持续性身体残疾的复合;该终点结果在本刊的另外文章中报道。次要终点为大出血和心血管疾病(定义为致命性冠心病、非致命性心肌梗死、致命性或非致命性卒中心衰住院)。

结果:纳入试验的19114人中,阿司匹林组9525人,安慰剂组9589人。中位随访4.7年后,阿司匹林和安慰剂组心血管疾病发生率分别为10.7例/1000人-年和11.3例/1000人-年(风险比[HR],0.95;95% 置信区间[CI],0.83~1.08)。大出血发生率分别为8.6例/1000人-年和6.2例/1000人-年(HR,1.38;95% CI,1.18~1.62;P<0.001)。

结论:与安慰剂相比,低剂量阿司匹林作为老年人一级预防策略会造成显着较高的大出血风险,不会造成显着较低的心血管疾病风险。(ASPREE ClinicalTrials.gov编号,NCT01038583)

原始出处:
McNeil JJ, Wolfe R, Woods RL, et al.Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly.N Engl J Med. 2018 Sep 16. doi: 10.1056/NEJMoa1805819. [Epub ahead of print]

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    2019-02-05 spoonycyy
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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Oct 05 08:11:06 CST 2018, time=2018-10-05, status=1, ipAttribution=)]
    2019-06-27 haouestc
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createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Dec 04 17:58:58 CST 2018, time=2018-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=353286, encodeId=f84b3532862d, content=阿司匹林对健康老年人心血管事件。, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Nov 21 22:08:20 CST 2018, time=2018-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352045, encodeId=e8cc352045e5, content=阿司匹林对健康老年人的影响。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Oct 28 18:39:15 CST 2018, time=2018-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349661, encodeId=bded349661cd, content=阿司匹林对老年人心血管。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Oct 17 15:47:30 CST 2018, time=2018-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347985, encodeId=b45a34e985ee, content=阿司匹林对健康老年人心血管事件。, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Oct 05 08:11:06 CST 2018, time=2018-10-05, status=1, ipAttribution=)]
    2018-12-04 jyzxjiangqin

    阿司匹林对健康老年人心血管事件。

    0

  5. 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createdName=hukaixun, createdTime=Tue Mar 19 15:43:00 CST 2019, time=2019-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1785531, encodeId=7a421e855318a, content=<a href='/topic/show?id=34b86e91f9' target=_blank style='color:#2F92EE;'>#Engl#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6791, encryptionId=34b86e91f9, topicName=Engl)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7eeb2500172, createdName=haouestc, createdTime=Thu Jun 27 11:43:00 CST 2019, time=2019-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=354440, encodeId=7b883544405d, content=阿司匹林对健康老年人心血管事件。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Dec 04 17:58:58 CST 2018, time=2018-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=353286, encodeId=f84b3532862d, content=阿司匹林对健康老年人心血管事件。, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Nov 21 22:08:20 CST 2018, time=2018-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352045, encodeId=e8cc352045e5, content=阿司匹林对健康老年人的影响。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Nov 09 14:10:29 CST 2018, time=2018-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352046, encodeId=e48a352046c0, content=阿司匹林对健康老年人的影响。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Nov 09 14:10:26 CST 2018, time=2018-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350790, encodeId=27b6350e9055, content=阿司匹林对健康老年人心脏管疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Oct 28 18:39:15 CST 2018, time=2018-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349661, encodeId=bded349661cd, content=阿司匹林对老年人心血管。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Oct 17 15:47:30 CST 2018, time=2018-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347985, encodeId=b45a34e985ee, content=阿司匹林对健康老年人心血管事件。, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Oct 05 08:11:06 CST 2018, time=2018-10-05, status=1, ipAttribution=)]
    2018-11-21 jyzxjiangqin

    阿司匹林对健康老年人心血管事件。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2081483, encodeId=36672081483f2, content=<a href='/topic/show?id=57406e8506' target=_blank style='color:#2F92EE;'>#Eng#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6785, encryptionId=57406e8506, topicName=Eng)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Tue Feb 05 19:43:00 CST 2019, time=2019-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643570, encodeId=bded16435e066, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Tue Mar 19 15:43:00 CST 2019, time=2019-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1785531, encodeId=7a421e855318a, content=<a href='/topic/show?id=34b86e91f9' target=_blank style='color:#2F92EE;'>#Engl#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6791, encryptionId=34b86e91f9, topicName=Engl)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7eeb2500172, createdName=haouestc, createdTime=Thu Jun 27 11:43:00 CST 2019, time=2019-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=354440, encodeId=7b883544405d, content=阿司匹林对健康老年人心血管事件。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Dec 04 17:58:58 CST 2018, time=2018-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=353286, encodeId=f84b3532862d, content=阿司匹林对健康老年人心血管事件。, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Nov 21 22:08:20 CST 2018, time=2018-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352045, encodeId=e8cc352045e5, content=阿司匹林对健康老年人的影响。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Nov 09 14:10:29 CST 2018, time=2018-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352046, encodeId=e48a352046c0, content=阿司匹林对健康老年人的影响。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Nov 09 14:10:26 CST 2018, time=2018-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=350790, encodeId=27b6350e9055, content=阿司匹林对健康老年人心脏管疾病。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Oct 28 18:39:15 CST 2018, time=2018-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349661, encodeId=bded349661cd, content=阿司匹林对老年人心血管。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Oct 17 15:47:30 CST 2018, time=2018-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347985, encodeId=b45a34e985ee, content=阿司匹林对健康老年人心血管事件。, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Oct 05 08:11:06 CST 2018, time=2018-10-05, status=1, ipAttribution=)]
    2018-11-09 jyzxjiangqin

    阿司匹林对健康老年人的影响。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2081483, encodeId=36672081483f2, content=<a href='/topic/show?id=57406e8506' target=_blank style='color:#2F92EE;'>#Eng#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6785, encryptionId=57406e8506, topicName=Eng)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Tue Feb 05 19:43:00 CST 2019, time=2019-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643570, encodeId=bded16435e066, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, 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createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Dec 04 17:58:58 CST 2018, time=2018-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=353286, encodeId=f84b3532862d, content=阿司匹林对健康老年人心血管事件。, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Nov 21 22:08:20 CST 2018, time=2018-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352045, encodeId=e8cc352045e5, content=阿司匹林对健康老年人的影响。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Oct 05 08:11:06 CST 2018, time=2018-10-05, status=1, ipAttribution=)]
    2018-11-09 jyzxjiangqin

    阿司匹林对健康老年人的影响。

    0

  8. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Oct 05 08:11:06 CST 2018, time=2018-10-05, status=1, ipAttribution=)]
    2018-10-28 jyzxjiangqin

    阿司匹林对健康老年人心脏管疾病。

    0

  9. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Oct 05 08:11:06 CST 2018, time=2018-10-05, status=1, ipAttribution=)]
    2018-10-17 jyzxjiangqin

    阿司匹林对老年人心血管。

    0

  10. 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    2018-10-05 jyzxjiangqin

    阿司匹林对健康老年人心血管事件。

    0

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