Does aspirin prevent venous thromboembolism?
Does aspirin prevent venous thromboembolism?
复制标题
DOI：
10.1182/hematology.2020000150
复制
发表时间：
2020-12-04
影响因子：
3
通讯作者：
Garcia, David
中科院分区：
文献类型：
--
作者：
Diep, Robert;Garcia, David
静脉血栓栓塞症(VTE；深静脉血栓形成和/或肺栓塞)是内科和外科患者群体中发病率和死亡率的公认原因。预防和治疗VTE的临床研究一直是一个动态的研究领域，从机械预防到直接口服抗凝剂，对各种治疗方式进行了调查。长期以来，阿司匹林一直是动脉血管疾病治疗的廉价基石，但它在VTE一级或二级预防中的作用一直存在争议。阿司匹林和抗凝剂之间的风险和利益权衡已经改变，部分原因是手术技术和术后护理的进步，部分原因是安全、易于使用的口服抗凝剂的发展。我们综述了阿司匹林可能作用于静脉血栓形成的机制，阿司匹林用于静脉血栓栓塞一级和二级预防的证据，以及阿司匹林与抗凝药物相比出血的风险。
Venous thromboembolism (VTE; deep vein thrombosis and/or pulmonary embolism) is a well-established cause of morbidity and mortality in the medical and surgical patient populations. Clinical research in the prevention and treatment of VTE has been a dynamic field of study, with investigations into various treatment modalities ranging from mechanical prophylaxis to the direct oral anticoagulants. Aspirin has long been an inexpensive cornerstone of arterial vascular disease therapy, but its role in the primary or secondary prophylaxis of VTE has been debated. Risk-benefit tradeoffs between aspirin and anticoagulants have changed, in part due to advances in surgical technique and postoperative care, and in part due to the development of safe, easy-to-use oral anticoagulants. We review the proposed mechanisms in which aspirin may act on venous thrombosis, the evidence for aspirin use in the primary and secondary prophylaxis of VTE, and the risk of bleeding with aspirin as compared with anticoagulation.