International Circulation: Do gastrointestinal side effects trouble the choice of optimal dose of aspirin in the results of CURRENT OASIS 7?
《国际循环》:在CURRENT OASIS 7研究结果中,胃肠道不良反应是否困扰了阿司匹林最佳剂量的选择?
International Circulation: As for gastrointestinal (GI) side-effects, there were 17 more GI bleeds in the high-dose aspirin arm compared to the low-dose aspirin arm. It did not quite reach statistical significance. When we consider that there were 25,000 patients in this trial, a 17 patient excess is incredibly small. On the other hand, the double dose clopidogrel and high-dose aspirin combination seemed to result in the lowest event rates. Therefore, one could consider high-dose aspirin for a month and the double dose clopidogrel for a week. It seems to be a safe and effective combination. After one month the low-dose aspirin can be reinstituted and after one week the standard dose clopidogrel (75 mg) can be used.
S R Mehta教授:在胃肠道不良反应上,与小剂量阿司匹林组相比,大剂量阿司匹林组胃肠道出血多了17例。这并未完全达到统计学显著性。当我们考虑到在这一研究中共有25 000例患者,这17例的增多是非常小的数字。另一方面,氯吡格雷双倍剂量联合大剂量阿司匹林似乎事件发生率最低。因此,可以考虑大剂量阿司匹林应用1月且氯吡格雷双倍计量应用1周。 这看似一种安全有效的联合。1个月后则重新应用小剂量阿司匹林,以及1周后应用标准剂量的氯吡格雷(75 mg/d)。
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