单独或联合使用氯吡格雷与低剂量阿司匹林,或可降低结直肠癌风险
创作:szx 审核:szx 2019年06月10日
  • 纳入2001-2014年间来自西班牙的15491名结直肠癌患者及60000名健康对照,进行一项巢式病例对照研究,记录受试者抗血小板药物的使用情况;
  • 单独使用低剂量阿司匹林,或单独使用氯吡格雷,均与较低的结直肠癌风险显著相关;
  • 在单独使用低剂量阿司匹林或氯吡格雷1年以上的患者中,结直肠癌风险也显著降低;
  • 联合使用低剂量阿司匹林及氯吡格雷,也与较低的结直肠癌风险显著相关;
  • 性别及年龄对上述关联无影响。
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szx
Clinical Gastroenterology and Hepatology上发表的一项巢式病例对照研究结果,发现在使用抗血小板药物(氯吡格雷或阿司匹林)的患者中,结直肠癌的风险显著降低。
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Clopidogrel and Low-Dose Aspirin, Alone or Together, Reduce Risk of Colorectal Cancer

单独或联合使用氯吡格雷与低剂量阿司匹林可降低结直肠癌风险

10.1016/j.cgh.2018.12.012

2018-12-20, Article

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BACKGROUND & AIMS: The antiplatelet effect of low-dose aspirin, via inhibition of cyclooxygenase-1, might contribute to its ability to reduce risk of colorectal cancer (CRC). Antiplatelet agents with a different mechanism, such as clopidogrel, might have the same effects. We aimed to quantify the effects of low-dose aspirin and clopidogrel on risk of CRC in a Mediterranean population.
METHODS: We performed a nested case-control study using a primary care database (BIFAP) in Spain. We collected data, from 2001 through 2014, on 15,491 incident cases of CRC and 60,000 randomly selected individuals (controls), frequency-matched to cases by age, sex, and year. To estimate the association between exposure to different antiplatelet agents and risk of colorectal cancer, we built multiple logistic regression models and computed the adjusted-odds ratios (AOR) and their respective 95% CIs.
RESULTS: Use of low-dose aspirin was associated with a reduced risk of CRC overall (AOR, 0.83; 95% CI, 0.78-0.89) and in patients receiving treatment for more than 1 year (AOR, 0.79; 95% CI, 0.73-0.85). Use of clopidogrel was associated with a decreased risk of CRC overall (AOR, 0.8; 95% CI, 0.69-0.93) and in patients receiving treatment for more than 1 year (AOR, 0.65; 95% CI, 0.55-0.78). Dual antiplatelet therapy had the same effect as either drug taken as monotherapy. No modification by sex or age was observed.
CONCLUSION: In a nested case-control study of a primary care database in Spain, we found clopidogrel use, alone or in combination with low-dose aspirin, to reduce risk of CRC by 20%-30%, a magnitude similar to that of low-dose aspirin alone. These data support the concept that inhibiting platelets is an effective strategy for prevention of CRC.

First Authors:
Antonio Rodríguez-Miguel

Correspondence Authors:
Francisco J de Abajo

All Authors:
Antonio Rodríguez-Miguel,Luis A García-Rodríguez,Miguel Gil,Héctor Montoya,Sara Rodríguez-Martín,Francisco J de Abajo

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