Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: US Preventive Services Task Force Recommendation Statement
Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: US Preventive Services Task Force Recommendation Statement
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DOI：
10.7326/m16-0577
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发表时间：
2016-06-21
影响因子：
39.2
通讯作者：
Bibbins-Domingo, Kirsten
中科院分区：
文献类型：
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作者：
Bibbins-Domingo, Kirsten
描述：USPSTF 2009年关于使用阿司匹林预防心血管疾病(CVD)事件的建议和2007年关于使用阿司匹林和非类固醇抗炎药物预防结直肠癌(CRC)的建议的更新。方法：USPSTF回顾了另外5项关于阿司匹林用于心血管疾病一级预防的研究和对CRC随访数据的额外分析。USPSTF还依赖于委托对全原因死亡率和总癌症发病率和死亡率进行的系统审查，以及对危害的全面审查。然后，USPSTF使用一个微观模拟模型来系统地评估益处和危害的平衡。人口：这一建议适用于40岁或以上的成年人，没有已知的心血管疾病，也没有增加出血风险。建议：USPSTF建议在50到59岁的成年人中开始使用低剂量阿司匹林作为心血管疾病和结直肠癌的一级预防，这些人有10%或更高的10年心血管疾病风险，没有增加出血风险，预期寿命至少10年，并愿意在至少10年内每天服用低剂量阿司匹林。(B)在60岁至69岁的成年人中开始使用小剂量阿司匹林作为心血管疾病和结直肠癌一级预防的决定应是个人的决定，这些成年人的10年心血管疾病风险为10%或以上。那些出血风险不增加，预期寿命至少10年，并愿意在至少10年内每天服用低剂量阿司匹林的人更有可能受益。那些认为潜在益处高于潜在危害的人可能会选择开始服用低剂量的阿司匹林。(c建议)目前的证据不足以评估在50岁以下的成年人中开始使用阿司匹林作为心血管疾病和结直肠癌一级预防的利弊平衡。(我的声明)目前的证据不足以评估开始使用阿司匹林对70岁或70岁以上的成年人进行心血管疾病和结直肠癌一级预防的利弊平衡。(i声明)
Description: Update of the 2009 USPSTF recommendation on aspirin use to prevent cardiovascular disease (CVD) events and the 2007 recommendation on aspirin and nonsteroidal anti-inflammatory drug use to prevent colorectal cancer (CRC).Methods: The USPSTF reviewed 5 additional studies of aspirin for the primary prevention of CVD and several additional analyses of CRC follow-up data. The USPSTF also relied on commissioned systematic reviews of all-cause mortality and total cancer incidence and mortality and a comprehensive review of harms. The USPSTF then used a microsimulation model to systematically estimate the balance of benefits and harms.Population: This recommendation applies to adults aged 40 years or older without known CVD and without increased bleeding risk.Recommendations: The USPSTF recommends initiating low-dose aspirin use for the primary prevention of CVD and CRC in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years. (B recommendation)The decision to initiate low-dose aspirin use for the primary prevention of CVD and CRC in adults aged 60 to 69 years who have a 10% or greater 10-year CVD risk should be an individual one. Persons who are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years are more likely to benefit. Persons who place a higher value on the potential benefits than the potential harms may choose to initiate low-dose aspirin. (C recommendation)The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults younger than 50 years. (I statement)The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults aged 70 years or older. (I statement)