Аспирин 100 через день для первичной профилактики ССЗ у женщих старше 45

[Dr.Vad]

Посвящается празднику 8 Марта?

Results from the Women's Health Study, released at a U.S. healthcare conference Monday, show low-dose aspirin did not prevent first heart attacks in women.

Dr. Elizabeth G. Nabel, director of the National Heart, Lung and Blood Institute of the National Institutes of Health, said in a statement the study, which ran for 10 years and included nearly 40,000 healthy women ages 45 and older, was the first large clinical trial to look at low-dose aspirin and heart attack and stroke in women. A positive correlation has been shown for men taking aspirin.

Nabel said while aspirin did not prevent first heart attacks or death from cardiovascular causes in women, it did lower the incidence of stroke by 17% (TIA - 22%).

In a sub-group of women, ages 65 and older, low-dose aspirin did reduce the risk of major cardiovascular events by 26%.

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A Randomized Trial of Low-Dose Aspirin in the Primary Prevention of Cardiovascular Disease in Women

Paul M Ridker et al.

Background
Randomized trials have shown that low-dose aspirin decreases the risk of a first myocardial infarction in men, with little effect on the risk of ischemic stroke. There are few similar data in women.

Methods
We randomly assigned 39,876 initially healthy women 45 years of age or older to receive 100 mg of aspirin on alternate days or placebo and then monitored them for 10 years for a first major cardiovascular event (i.e., nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes).

Results
During follow-up, 477 major cardiovascular events were confirmed in the aspirin group, as compared with 522 in the placebo group, for a nonsignificant reduction in risk with aspirin of 9 percent (relative risk, 0.91; 95 percent confidence interval, 0.80 to 1.03; P=0.13). With regard to individual end points, there was a 17 percent reduction in the risk of stroke in the aspirin group, as compared with the placebo group (relative risk, 0.83; 95 percent confidence interval, 0.69 to 0.99; P=0.04), owing to a 24 percent reduction in the risk of ischemic stroke (relative risk, 0.76; 95 percent confidence interval, 0.63 to 0.93; P=0.009) and a nonsignificant increase in the risk of hemorrhagic stroke (relative risk, 1.24; 95 percent confidence interval, 0.82 to 1.87; P=0.31). As compared with placebo, aspirin had no significant effect on the risk of fatal or nonfatal myocardial infarction (relative risk, 1.02; 95 percent confidence interval, 0.84 to 1.25; P=0.83) or death from cardiovascular causes (relative risk, 0.95; 95 percent confidence interval, 0.74 to 1.22; P=0.68). Gastrointestinal bleeding requiring transfusion was more frequent in the aspirin group than in the placebo group (relative risk, 1.40; 95 percent confidence interval, 1.07 to 1.83; P=0.02). Subgroup analyses showed that aspirin significantly reduced the risk of major cardiovascular events, ischemic stroke, and myocardial infarction among women 65 years of age or older.

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