Triflusal防止严重血管事件的高危人群。
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科斯塔J,铁JM, Matias-Guiu J, Alvarez-Sabin J,托雷斯F
Triflusal防止严重血管事件的高危人群。
科克伦数据库系统启2005 7月20;(3):CD004296。
- PubMed ID
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16034926 (在PubMed]
- 文摘
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背景:阿司匹林是标准的二级预防治疗中风和其他血管事件。几项研究表明,triflusal可能有更好的安全性。目的:确定高危人群的血管事件是否triflusal是一种有效和安全的一级预防和二级预防治疗的严重血管事件。搜索策略:我们搜查了试验注册下面的科克伦评论组:中风组(2004年10月最后一次搜索),心脏组织、外周血管疾病组和代谢和内分泌紊乱组(去年在2003年5月)。此外,我们搜查了科克伦中心注册的对照试验(中央)(Cochrane图书馆问题2,2003),MEDLINE(1977 - 2003)和EMBASE (1980 - 2003)。我们在参考列表和该领域的研究人员联系,作者的相关试验和药物制造商。选择标准:随机和quasi-randomised研究比较与安慰剂或阿司匹林triflusal血管事件的高危人群。数据收集和分析:两位作者独立评估试验质量和提取数据。主要的结果是一个严重血管事件(非致命的急性心肌梗死(AMI)、非致命缺血性或出血性卒中发生,或血管性死亡)。其他有效性和安全性措施收集频率不同的血管事件,不良事件,轻度和重度出血。 MAIN RESULTS: (1) Aspirin versus triflusal: five studies enrolled patients with stroke or transient ischemic attack (TIA) (4 trials; 2944 patients; followed for 6 to 47 months) or AMI (one trial; 2275 patients; followed for 35 days). Entry criteria were similar within each subgroup of patients. Patient groups were appropriately selected and well matched. The primary outcome in all trials was a composite outcome of vascular events. Trials had no important bias except in one study (217 patients). For the primary outcome of a serious vascular event there was no significant difference between triflusal and aspirin; the odds ratio (OR) was 1.04 (95% confidence interval (CI) 0.87 to 1.23). Significant differences were found for frequency of hemorrhages, both minor (OR 1.60, 95% CI 1.31 to 1.95) and major (OR 2.34, 95% CI 1.58 to 3.46) and for non-hemorrhagic gastrointestinal adverse events (OR 0.84, 95% CI 0.75 to 0.95). Sensitivity analysis of well versus poorly allocated trials showed no significant differences. (2) Triflusal versus placebo: two trials enrolled patients with unstable angina (281 patients) or peripheral arteriopathy (122 patients), who were followed for 6 months. Triflusal was associated with a reduction in serious vascular events (OR 2.29, 95% CI 1.01 to 5.19; OR greater than 1 favours triflusal) and with a higher frequency of adverse events (OR 1.68, 95% CI 1.00 to 2.80). AUTHORS' CONCLUSIONS: No significant differences were found between triflusal and aspirin for secondary prevention of serious vascular events in patients with stroke or TIA and AMI. However, our review cannot exclude moderate differences in efficacy. Triflusal was associated with a lower risk of hemorrhagic complications.
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