The effect of chronic platelet inhibition with low-dose aspirin on atherosclerotic progression and acute thrombosis: clinical evidence from the Physicians' Health Study.
The effect of chronic platelet inhibition with low-dose aspirin on atherosclerotic progression and acute thrombosis: clinical evidence from the Physicians' Health Study.
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小剂量阿司匹林慢性血小板抑制对动脉粥样硬化进展和急性血栓形成的影响：来自医生健康研究的临床证据。
DOI：
10.1016/0002-8703(91)90275-m
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发表时间：
1991
影响因子：
4.8
通讯作者：
Hennekens,CH
中科院分区：
文献类型：
--
作者：
Ridker,PM;Manson,JE;Buring,JE;Goldhaber,SZ;Hennekens,CH
低剂量阿司匹林被认为可以通过影响动脉粥样硬化的进展和急性血栓形成来降低心血管疾病的风险。在医生健康研究中，一项随机双盲安慰剂对照试验隔天服用阿司匹林（325毫克），22,071名表面上健康的男性医生接受了治疗，并随访了5年，观察心肌梗死和新发心绞痛的发生情况。在对这些终点的累积发生率和累积相对风险的分析中，发现阿司匹林在降低心肌梗死风险方面的充分保护作用在治疗开始后不久就很明显，并且不随时间改变。相反，长期阿司匹林治疗在降低未来发生心绞痛的风险方面没有明显的作用。综上所述，这些临床观察支持预防性低剂量阿司匹林治疗的主要作用是抑制急性血栓形成的假设，但不支持长达5年的长期血小板抑制可以减缓动脉粥样硬化的发生和进展的假设。
Low-dose aspirin has been postulated to decrease risks of cardiovascular disease by affecting atherosclerotic progression as well as acute thrombosis. In the Physicians' Health Study, a randomized double-blind placebo-controlled trial of alternate day aspirin (325 mg), 22, 071 apparently healthy male physicians were treated and followed over a period of 5 years for the occurrence of myocardial infarction and of new angina pectoris. In an analysis of the cumulative incidence and cumulative relative risks of these end points, it was found that the full protective effect of aspirin in reducing the risk of myocardial infarction is apparent soon after initiation of therapy and does not change over time. In contrast, long-term aspirin therapy has no apparent role in decreasing the risk of developing future angina pectoriss. Taken together, these clinical observations support the hypothesis that the primary effect of prophylactic low-dose aspirin therapy is to inhibit acute thrombosis, but do not support the hypothesis that long-term platelet inhibition for a duration of up to 5 years slows the initiation and progression of atherosclerosis.