纽约（路透社健康版）12月27日－据《欧洲心脏杂志》11月刊报道，冠状动脉疾病患者中断服用阿司匹林将导致发生主要心脏不良事件的风险增加。
意大利都灵大学的Giuseppe G. L. Biondi-Zoccai博士告诉路透社健康专栏：“即使在外科手术前也不应该中断阿司匹林治疗（唯一例外的可能是颅内手术，或者经尿道前列腺切除术），因为，很明显，心血管血栓形成的风险超过了任何出血的风险。”
Biondi-Zoccai博士和他的同事对6项已发表的研究进行了系统回顾和荟萃分析，以评估中断或未坚持服用阿司匹林对冠心病高危人群或冠心病患者的危险性。
结果显示，急性冠脉综合征或冠心病患者中断或未坚持服用阿司匹林，其主要心脏不良事件的风险增加82％。心脏外科手术前停服阿司匹林或未遵医嘱服用阿司匹林，不良事件的危险增加2.2倍。在联合分析中，停服阿司匹林/未遵医嘱服用阿司匹林导致不良事件的风险显著增加3.14倍。
报道指出，停药和血栓事件之间平均10.66天。研究者称：“这些结果看起来与血小板的半衰期一致，表明在出血高危患者行大型侵入治疗而必须中断阿司匹林的情况下，应该在8～10天之内重新开始正确服用阿司匹林。Biondi-Zoccai博士认为，确保和建议所有患者坚持服用阿司匹林是简单、经济、有效的医疗措施。
Aspirin Discontinuation Increases Risks for Coronary Artery Disease Patients
By Will Boggs, MD
NEW YORK (Reuters Health) Dec 27 - Coronary artery disease patients who discontinue their aspirin face an increased risk for major adverse cardiac events, according to a report in the November European Heart Journal.
"Aspirin should not be discontinued even before surgery (the only exception is likely intracranial surgery, and possibly transurethral prostatectomy), as any bleeding risk is clearly overwhelmed by cardiovascular thrombotic risks," Dr. Giuseppe G. L. Biondi-Zoccai from the University of Turin, Italy told Reuters Health.
Dr. Biondi-Zoccai and colleagues undertook a systematic review and meta-analysis of 6 published studies to assess the hazards of discontinuing or not adhering to aspirin in patients at risk for or with coronary artery disease.
Among patients with acute coronary syndrome or coronary artery disease, discontinuing or not adhering to aspirin treatment was associated with an 82% increase in the risk of adverse events, the authors report.
Aspirin discontinuation or noncompliance before cardiac surgery was associated with a 2.2-fold increased risk of adverse events, the results indicate.
In the pooled analysis, aspirin withdrawal/noncompliance was associated with a significant 3.14-fold increased risk of adverse events.
An average of 10.66 days elapsed between drug withdrawal and thrombotic events, the report indicates.
"These results appear in line with the half-life of platelets, and suggest that in case of mandatory aspirin discontinuation for highly invasive interventions in patients at high risk of bleeding, the drug should be resumed well before that 8-10 days have elapsed," the researchers write.
"Thus ensuring and recommending all patients to adhere to aspirin treatment is a simple, cost-saving, and effective medical intervention," Dr. Biondi-Zoccai said.
Eur Heart J 2006;27:2667-2674.
http://www.medscape.com/viewarticle/549946
编辑：蓝色幻想
