【原】内科学年鉴：阿司匹林在心血管疾病与结直肠癌一级预防中的应用指南

急诊医学资讯 2020-10-21

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Ann Intern Med. Published online 12 April 2016 doi:10.7326/M16-0577

Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement

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Kirsten Bibbins-Domingo, PhD, MD, MAS, on behalf of the U.S. Preventive Services Task Force

推荐意见如下：

The USPSTF recommends initiating low-dose aspirin use (81mg/天) for the primary prevention of CVD（非致死性心梗与中风） 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)

注：有关10年风险计算公式的推荐意见如下：

Recommendation 1. The race- and sex-specific Pooled Cohort Equations∗ to predict 10-year risk of a first hard ASCVD event should be used in non-Hispanic African Americans and non-Hispanic whites, 40 to 79 years of age.

NHLBI Grade: B (Moderate); ACC/AHA COR: I; LOE: B

Recommendation 2. Use of the sex-specific Pooled Cohort Equations for non-Hispanic whites may be considered for estimation of risk in patients from populations other than African Americans and non-Hispanic whites.

NHLBI Grade: E (Expert Opinion); ACC/AHA COR: IIb; LOE: C

10年风险计算公式已经制成app软件啦！

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