一级预防的抗栓：现状与未演示文稿.pptVIP

Study design Aspirin daily (100 mg) (n~6,000) Placebo 1 tablet daily (n~6,000) 12-month visit R=Randomization; *First occurrence of composite outcome of MI, stroke, or cardiovascular death; +Telephone contact Patients (n=12,000) at moderate risk of CVD events R Double-blind treatment up to 1,488 primary efficacy events* 3-month visit Visits every 12 months + + + + + + + + + + + + + + ARRIVE Trial: Inclusion Criteria Males aged 50 to 75 years with 2 or 3 CV risk factors Females aged 60 and above with 3 or more CV risks factors ARRIVE Trial: Primary efficacy endpoint Composite outcome consisting of the first ocurrence of cardiovascular death, MI, or stroke. Summary of the ARRIVE Trial ARRIVE is one of the largest aspirin studies ever conducted in a population at moderate risk of initial cardiovascular and cerebrovascular events ARRIVE creates additional opportunities to communicate the positive benefits of aspirin and address the problem of underutilization A meta-analysis of six primary prevention trials demonstrated a positive trend for reduced risk of stroke with low-dose acetylsalicylic acid (LD-ASA); however, the confidence interval was wide (0.84–1.06) and was therefore not statistically significant (p=0.336).1 In the Primary Prevention Project, LD-ASA was associated with a nonsignificant 33% reduction in the risk of first stroke.2 The Thrombosis Prevention Trial demonstrated a nonsignificant 31% reduction in the risk of thrombotic stroke with LD-ASA therapy compared with control.3 The Women’s Health Study demonstrated a significant 17% reduction in the risk of first stroke in women aged ?45 years.4 In the Hypertension Optimal Treatment study, no effect of LD-ASA on the overall rate of stroke was observed.5 In the British Doctors’ Trial4 and the Physicians’ Health Study,6 there was a trend towards increased risk for stroke in those receiving LD-ASA. For these reasons, the overall summary estimate demonstrated no difference in total stroke (odds