阿司匹林
医学
观察研究
优势比
混淆
随机对照试验
荟萃分析
相对风险
置信区间
癌症
心肌梗塞
疾病
内科学
重症监护医学
作者
Paul Moayyedi,Janusz Jankowski
出处
期刊:BMJ
[BMJ]
日期:2010-12-22
卷期号:341 (dec22 1): c7326-c7326
被引量:15
摘要
Potentially, but trials specifically designed to answer this question are needed
The cardioprotective effects of aspirin are well established. A meta-analysis of individual subject data from primary prevention randomised controlled trials (RCTs) suggested that aspirin can reduce the relative risk of non-fatal myocardial infarction by about 20%.1 Overall, however, the risks of treatment (severe gastrointestinal and extracranial bleeding) were roughly the same as the benefits, so routine use of aspirin as a primary preventive strategy was not recommended. The meta-analysis did not evaluate any potential reduction of mortality from cancer, as has been suggested by observational data.2 Observational data are difficult to interpret, however, because associations may not be causal and may be the result of confounding or bias.3 Rothwell and colleagues have therefore conducted another meta-analysis of individual subject data from RCTs of aspirin versus no aspirin for prevention of vascular disease, but this time they evaluated mortality from cancer as the main outcome.4 They found a 21% (95% confidence interval 8% to 32%) reduction in the odds of death from cancer in people who took aspirin for almost six years, and the effect was strongest for gastrointestinal cancers. The authors …
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