NEJM:你吃对了吗——冠心病患者阿司匹林的更佳剂量是多少?

2021-05-16 MedSci原创 MedSci原创

每天服用81mg与325mg克阿司匹林的患者在心血管事件或大出血方面没有显著差异。

冠状动脉粥样硬化心脏病,简称冠心病,是因为心脏血管内长期垃圾堆积,形成斑块导致狭窄。这个斑块斑块如果破裂,就会形成血栓,堵死血管,发生急性心肌梗死,危及生命。阿司匹林具有抗血小板的作用,也就是预防这种血栓形成,所以冠心病要服用阿司匹林。 之前曾有大量研究说明阿司匹林在治疗多种疾病中的神奇与重要作用,但都比不上在冠心病中的地位:如果把冠心病的治疗看成一个人的话,那么阿司匹林就是这个人的一条腿,一旦没有这条腿,人就站不稳。 有研究显示:不稳定性心绞痛患者服用阿司匹林,可使心肌梗死的发生率和死亡率降低51%;急性心肌梗死患者早期使用阿司匹林,在每1000例患者中,可挽救25人的生命,并可预防10~15例复发心肌梗死和脑梗死。 由此可见,无论是理论还是实践都证明冠心病需要服用阿司匹林。然而,在已确诊的动脉粥样硬化性心血管疾病患者中,降低死亡、心肌梗塞和中风风险并尽量减少大出血的阿司匹林的最佳剂量是一个有争议的话题。 为了更好地确定阿司匹林的最佳剂量,由美国杜克大学心血管中心的专家牵头的国际ADAPTABLE协作组开展了一项开放标签、务实设计、随机对照试验,结果发表在近期的《新英格兰医学杂志》N

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1006774, encodeId=c2a41006e74fd, content=学习了 , beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6de91548468, createdName=qingbao2004, createdTime=Tue Aug 10 22:12:26 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447791, encodeId=36ad144e79170, content=<a href='/topic/show?id=523a3082670' target=_blank style='color:#2F92EE;'>#冠心病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30826, encryptionId=523a3082670, topicName=冠心病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=99445365987, createdName=liubm557, createdTime=Tue May 18 07:41:20 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035649, encodeId=88fa1035649f4, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sun May 16 19:41:20 CST 2021, time=2021-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966050, encodeId=5a1c966050aa, content=好文章!, 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=Sun May 16 16:51:10 CST 2021, time=2021-05-16, status=1, ipAttribution=)]
    2021-08-10 qingbao2004

    学习了

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1006774, encodeId=c2a41006e74fd, content=学习了 , beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6de91548468, createdName=qingbao2004, createdTime=Tue Aug 10 22:12:26 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447791, encodeId=36ad144e79170, content=<a href='/topic/show?id=523a3082670' target=_blank style='color:#2F92EE;'>#冠心病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30826, encryptionId=523a3082670, topicName=冠心病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=99445365987, createdName=liubm557, createdTime=Tue May 18 07:41:20 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035649, encodeId=88fa1035649f4, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sun May 16 19:41:20 CST 2021, time=2021-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966050, encodeId=5a1c966050aa, content=好文章!, 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=Sun May 16 16:51:10 CST 2021, time=2021-05-16, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1006774, encodeId=c2a41006e74fd, content=学习了 , beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6de91548468, createdName=qingbao2004, createdTime=Tue Aug 10 22:12:26 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447791, encodeId=36ad144e79170, content=<a href='/topic/show?id=523a3082670' target=_blank style='color:#2F92EE;'>#冠心病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30826, encryptionId=523a3082670, topicName=冠心病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=99445365987, createdName=liubm557, createdTime=Tue May 18 07:41:20 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035649, encodeId=88fa1035649f4, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sun May 16 19:41:20 CST 2021, time=2021-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966050, encodeId=5a1c966050aa, content=好文章!, 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=Sun May 16 16:51:10 CST 2021, time=2021-05-16, status=1, ipAttribution=)]
    2021-05-16 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1006774, encodeId=c2a41006e74fd, content=学习了 , beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6de91548468, createdName=qingbao2004, createdTime=Tue Aug 10 22:12:26 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447791, encodeId=36ad144e79170, content=<a href='/topic/show?id=523a3082670' target=_blank style='color:#2F92EE;'>#冠心病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30826, encryptionId=523a3082670, topicName=冠心病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=99445365987, createdName=liubm557, createdTime=Tue May 18 07:41:20 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035649, encodeId=88fa1035649f4, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sun May 16 19:41:20 CST 2021, time=2021-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966050, encodeId=5a1c966050aa, content=好文章!, 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=Sun May 16 16:51:10 CST 2021, time=2021-05-16, status=1, ipAttribution=)]
    2021-05-16 jyzxjiangqin

    好文章!

    0

相关资讯

BMJ Gastroenterology:低剂量阿司匹林引发低胃肠道出血并降低结直肠肿瘤的风险

大肠癌(CRC)仍然是全世界最常见的胃肠道癌症,早期发现并清除癌前息肉可以防止随后的CRC发生。先前的研究表明长期连续服用阿司匹林与CRC风险呈负相关。

Clin Translational Gastroenterology:阿司匹林可以减少接受口服核苷类似物的慢性乙型肝炎患者的肝细胞癌发病率

肝细胞癌(HCC)是全球第二大癌症死亡的主要原因,全球每年诊断出的HCC病例超过500000例。

JAHA:导管主动脉瓣植入术后阿司匹林单药治疗与双重抗血小板治疗比较

在没有口服抗凝剂治疗指症的接受经导管主动脉瓣植入的患者中,与DAPT相比,阿司匹林单药治疗显著降低了经导管主动脉瓣植入后的血栓栓塞和出血事件的复合结局,而血栓栓塞事件的发生率并没有增加。

JNCI:定期服用阿司匹林可预防结直肠癌确诊后转移风险

诊断为非转移性结直肠癌之前长期服用阿司匹林可能与诊断后结直肠癌特异性死亡率较低相关。

EHJCP:他汀治疗可降低无阻塞性CAD的糖尿病患者的主要不良心血管事件风险,但阿司匹林不能!

对于无阻塞性CAD的糖尿病患者,阿司匹林治疗既不能降低MACE风险,也不会增加出血风险

J Periodontol:牙周清创后辅助ω-3多不饱和脂肪酸和低剂量阿司匹林有益于2型糖尿病患者的牙周炎治疗

研究人员提出补充ω-3多不饱和脂肪酸(ω-3 PUFA)和低剂量阿司匹林(ASA)作为控制慢性炎症性疾病的宿主调节方案。近日,研究人员探讨了口服ω-3 PUFA和A

拓展阅读

JAMA:阿司匹林治疗可减少复发性静脉血栓栓塞

研究者在《JAMA》杂志上报告,对于在首次无明确原因的静脉血栓栓塞事件后停用抗凝剂治疗的患者,每日阿司匹林治疗可显著降低复发性血栓事件风险。   在这项纳入402例患者的多中心、双盲的阿司匹林预防复发性静脉血栓栓塞[华法林和阿司匹林(WARFASA)]研究中,所有患者在随机化之前完成6~18个月的维生素K拮抗剂口服抗凝治疗。排除有癌症、血栓形成倾向或在抗凝剂治疗期间发生出血的患者,但