阿司匹林用于心血管疾病的初级预防:我们现在知道什么

Weisman Steven M, Angiolillo Dominick J
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引用次数: 0

摘要

心血管疾病(CVD),包括冠心病和中风,是导致全球死亡的主要原因。心血管疾病一级和二级预防方面的进步改善了患者的预后和疗效,但临床医生和患者必须及早进行风险因素筛查,并对可改变的心血管疾病风险因素进行预防性管理。除了降血脂和降血压药物外,阿司匹林因其抗血小板和抗炎活性,长期以来一直是预防心血管疾病的首选疗法。然而,最近有关心血管疾病一级预防临床指南更新的文章和报告导致人们对阿司匹林的推荐产生了混淆。本综述旨在评估阿司匹林在心血管疾病预防中的最新指导,以及如何适当识别可能受益于小剂量阿司匹林治疗的高危患者,将其作为心血管疾病预防保健选择的一部分。此外,本综述还将提供有关临床医生与患者对话的实际应用指导,以清楚地解释使用阿司匹林的益处和风险,并确保以患者为中心决定是否开始阿司匹林治疗。
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Aspirin for Primary Prevention of Cardiovascular Disease: What We Now Know
Cardiovascular disease (CVD), including coronary artery disease and stroke, is the leading cause of death worldwide. Advances in primary and secondary prevention of CVD have improved patient prognoses and outcomes, however, it is imperative that the clinician and patient engage in early risk factor screening and preventive management of modifiable risk factors for CVD. In addition to blood lipid and blood pressure lowering medications, aspirin has been a long-standing therapy targeted to the prevention of CVD based on its antiplatelet and anti-inflammatory activity. However, recent articles and reports on updates to clinical guidelines for the primary prevention of CVD have resulted in confusion about aspirin recommendations. This review aims to assess the latest guidance on aspirin in CVD prevention and how to identify appropriately at-risk patients who may benefit from low-dose aspirin therapy as part of their CVD preventive healthcare choices. Additionally, this review will provide practical application guidance about clinician-patient conversations to clearly explain the benefits and risks of aspirin use and ensure a patient-centric decision to initiate aspirin therapy.
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