{"id":35302,"date":"2024-05-22T05:13:00","date_gmt":"2024-05-21T21:13:00","guid":{"rendered":"https:\/\/docquity.com\/?post_type=articles&p=35302"},"modified":"2025-02-11T13:40:20","modified_gmt":"2025-02-11T05:40:20","slug":"chuyen-gi-dang-xay-ra-voi-aspirin","status":"publish","type":"articles","link":"https:\/\/docquity.com\/vi\/articles\/chuyen-gi-dang-xay-ra-voi-aspirin\/","title":{"rendered":"Chuy\u1ec7n g\u00ec \u0111ang x\u1ea3y ra v\u1edbi aspirin?"},"content":{"rendered":"\n

Vai tr\u00f2 c\u1ee7a aspirin trong \u1ee9c ch\u1ebf k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u v\u00e0 ph\u00f2ng ng\u1eeba th\u1ee9 ph\u00e1t c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh qua nhi\u1ec1u nghi\u00ean c\u1ee9u\u00a0[1]<\/sup>. L\u1ee3i \u00edch tr\u00ean tim m\u1ea1ch c\u1ee7a aspirin li\u1ec1u th\u1ea5p \u1edf b\u1ec7nh nh\u00e2n m\u1eafc h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed nh\u1ed3i m\u00e1u c\u01a1 tim, \u0111\u1ed9t qu\u1ef5, \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u tho\u00e1ng qua \u0111\u00e3 \u0111\u01b0\u1ee3c l\u00e0m r\u00f5 qua h\u01a1n 200 nghi\u00ean c\u1ee9u tr\u00ean t\u1ed5ng c\u1ed9ng h\u01a1n 200,000 b\u1ec7nh nh\u00e2n\u00a0[2]<\/sup>. Nhi\u1ec1u t\u1ed5 ch\u1ee9c y t\u1ebf \u0111\u00e3 khuy\u1ebfn c\u00e1o aspirin li\u1ec1u 75 \u2013 100 mg \u1edf b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 nh\u1ed3i m\u00e1u c\u01a1 tim\/\u0111\u1ed9t qu\u1ef5 trong 10 n\u0103m > 20%[3 \u2013 5]<\/sup>.<\/p>\n\n\n\n

Tuy l\u1ee3i \u00edch trong ph\u00f2ng ng\u1eeba bi\u1ebfn c\u1ed1 tim m\u1ea1ch th\u1ee9 ph\u00e1t c\u1ee7a aspirin \u0111\u00e3 \u0111\u01b0\u1ee3c l\u00e0m r\u00f5, tuy nhi\u00ean, vai tr\u00f2 c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u n\u00e0y trong ph\u00f2ng ng\u1eeba bi\u1ebfn c\u1ed1 tim m\u1ea1ch ti\u00ean ph\u00e1t \u1edf b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 trung b\u00ecnh l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 g\u00e2y ra nhi\u1ec1u tranh c\u00e3i m\u1eb7c d\u00f9 c\u00f3 nhi\u1ec1u th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh trong h\u01a1n 3 th\u1eadp k\u1ef7. Vi\u1ec7c di\u1ec5n gi\u1ea3i k\u1ebft qu\u1ea3 c\u1ee7a c\u00e1c th\u1eed nghi\u1ec7m n\u00e0y tr\u1edf n\u00ean ph\u1ee9c t\u1ea1p \u0111\u01b0\u1ee3c cho l\u00e0 v\u00ec nguy c\u01a1 g\u00e2y xu\u1ea5t huy\u1ebft c\u1ee7a aspirin \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 \u1edf nhi\u1ec1u m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau, t\u1eeb c\u00e1c bi\u1ebfn c\u1ed1 th\u01b0\u1eddng g\u1eb7p nh\u01b0 b\u1ea7m t\u00edm, ch\u1ea3y m\u00e1u cam cho \u0111\u1ebfn c\u00e1c bi\u1ebfn c\u1ed1 hi\u1ebfm g\u1eb7p h\u01a1n nh\u01b0ng g\u00e2y nguy hi\u1ec3m t\u00ednh m\u1ea1ng nh\u01b0 xu\u1ea5t huy\u1ebft d\u1ea1 d\u00e0y hay \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft.<\/p>\n\n\n\n

B\u1eb1ng ch\u1ee9ng \u0111\u1ea7u ti\u00ean v\u1ec1 ph\u00f2ng ng\u1eeba ti\u00ean ph\u00e1t c\u1ee7a aspirin<\/em><\/strong><\/h2>\n\n\n\n

V\u00e0o n\u0103m 1988, m\u1ed9t nghi\u00ean c\u1ee9u \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u0111\u1ec3 l\u00e0m r\u00f5 hi\u1ec7u l\u1ef1c ph\u00f2ng ng\u1eeba tim m\u1ea1ch ti\u00ean ph\u00e1t c\u1ee7a aspirin [6]<\/sup>. Nghi\u00ean c\u1ee9u bao g\u1ed3m 22,000 ng\u01b0\u1eddi tham gia nghi\u00ean c\u1ee9u, \u0111\u01b0\u1ee3c ph\u00e2n ng\u1eabu nhi\u00ean v\u00e0o 4 nh\u00f3m: (i) aspirin li\u1ec1u 325 mg v\u00e0 beta carotene placebo 50 mg; (ii) aspirin v\u00e0 beta carotene placebo; (iii) aspirin placebo v\u00e0 beta carotene v\u00e0 (iv) aspirin placebo v\u00e0 beta carotene placebo. Sau 4.8 n\u0103m theo d\u00f5i, s\u1ed1 l\u01b0\u1ee3ng bi\u1ebfn c\u1ed1 nh\u1ed3i m\u00e1u c\u01a1 tim x\u1ea3y ra \u1edf nh\u00f3m ng\u01b0\u1eddi \u0111i\u1ec1u tr\u1ecb v\u1edbi aspirin gi\u1ea3m g\u1ea7n 50%. \u0110\u1ed1i v\u1edbi bi\u1ebfn c\u1ed1 \u0111\u1ed9t qu\u1ef5, tuy kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a, nh\u01b0ng s\u1ed1 l\u01b0\u1ee3ng bi\u1ebfn c\u1ed1 \u0111\u1ed9t qu\u1ef5 x\u1ea3y ra nhi\u1ec1u h\u01a1n \u1edf nh\u00f3m b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb v\u1edbi aspirin. Kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t gi\u1eefa c\u00e1c nh\u00f3m v\u1ec1 s\u1ed1 l\u01b0\u1ee3ng t\u1eed vong do tim m\u1ea1ch ho\u1eb7c t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n [6]<\/sup>.<\/p>\n\n\n\n

B\u1eb1ng ch\u1ee9ng m\u1edbi ph\u1ee7 nh\u1eadn l\u1ee3i \u00edch ph\u00f2ng ng\u1eeba ti\u00ean ph\u00e1t: ASCEND, ARRIVE v\u00e0 ASPREE<\/em><\/strong><\/h2>\n\n\n\n

V\u00e0o n\u0103m 2018, 3 th\u1eed nghi\u1ec7m c\u00f3 quy m\u00f4 l\u1edbn v\u1ec1 l\u1ee3i \u00edch trong ph\u00f2ng ng\u1eeba tim m\u1ea1ch ti\u00ean ph\u00e1t c\u1ee7a aspirin ASCEND [7]<\/sup>, ARRIVE [8]<\/sup>, ASPREE [9]<\/sup> \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh. Nghi\u00ean c\u1ee9u ASCEND \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 hi\u1ec7u l\u1ef1c v\u00e0 t\u00ednh an to\u00e0n c\u1ee7a aspirin li\u1ec1u 100 mg\/ng\u00e0y \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng nh\u01b0ng ch\u01b0a m\u1eafc b\u1ec7nh tim m\u1ea1ch. Ti\u00eau ch\u00ed \u0111\u00e1nh gi\u00e1 ch\u00ednh c\u1ee7a nghi\u00ean c\u1ee9u bao g\u1ed3m bi\u1ebfn c\u1ed1 tim m\u1ea1ch nghi\u00eam tr\u1ecdng \u0111\u1ea7u ti\u00ean (nh\u1ed3i m\u00e1u c\u01a1 tim, \u0111\u1ed9t qu\u1ef5\/\u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u tho\u00e1ng qua ho\u1eb7c t\u1eed vong do nguy\u00ean nh\u00e2n tim m\u1ea1ch, ngo\u1ea1i tr\u1eeb xu\u1ea5t huy\u1ebft n\u1ed9i s\u1ecd). Ti\u00eau ch\u00ed an to\u00e0n bao g\u1ed3m bi\u1ebfn c\u1ed1 xu\u1ea5t huy\u1ebft nghi\u00eam tr\u1ecdng (xu\u1ea5t huy\u1ebft n\u1ed9i s\u1ecd, xu\u1ea5t huy\u1ebft n\u1ed9i nh\u00e3n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u1ea7m nh\u00ecn, xu\u1ea5t huy\u1ebft d\u1ea1 d\u00e0y ho\u1eb7c xu\u1ea5t huy\u1ebft kh\u00e1c). Nghi\u00ean c\u1ee9u bao g\u1ed3m 15,480 ng\u01b0\u1eddi tham gia. Qua h\u01a1n 7.4 n\u0103m theo d\u00f5i, t\u1ef7 l\u1ec7 b\u1ec7nh nh\u00e2n m\u1eafc c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch th\u1ea5p h\u01a1n c\u00f3 \u00fd ngh\u0129a \u1edf nh\u00f3m aspirin so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c (8.5% vs 9.6%). Ng\u01b0\u1ee3c l\u1ea1i, t\u1ef7 l\u1ec7 b\u1ec7nh nh\u00e2n m\u1eafc c\u00e1c bi\u1ebfn c\u1ed1 xu\u1ea5t huy\u1ebft nghi\u00eam tr\u1ecdng l\u1ea1i cao h\u01a1n c\u00f3 \u00fd ngh\u0129a \u1edf nh\u00f3m aspirin so v\u1edbi nh\u00f3m gi\u1ea3 d\u01b0\u1ee3c (4.1% vs 3.2%). Nh\u01b0 v\u1eady, nghi\u00ean c\u1ee9u ASCEND cho th\u1ea5y aspirin ph\u00f2ng ng\u1ef1a hi\u1ec7u qu\u1ea3 bi\u1ebfn c\u1ed1 tim m\u1ea1ch ti\u00ean ph\u00e1t nh\u01b0ng \u0111\u1ed3ng th\u1eddi l\u00e0m t\u0103ng nguy c\u01a1 xu\u1ea5t huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ch\u01b0a t\u1eebng m\u1eafc b\u1ec7nh tim m\u1ea1ch [7]<\/sup>.<\/p>\n\n\n\n

Th\u1eed nghi\u1ec7m ARRIVE \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u0111\u1ec3 l\u00e0m r\u00f5 hi\u1ec7u l\u1ef1c c\u1ee7a aspirin d\u1ea1ng bao tan trong ru\u1ed9t, li\u1ec1u 100 mg \/ng\u00e0y trong vi\u1ec7c l\u00e0m gi\u1ea3m bi\u1ebfn c\u1ed1 nh\u1ed3i m\u00e1u c\u01a1 tim, \u0111\u1ed9t qu\u1ef5 v\u00e0 c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch kh\u00e1c \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 tim m\u1ea1ch trung b\u00ecnh (nguy c\u01a1 b\u1ec7nh tim m\u1ea1ch v\u00e0nh 10 n\u0103m 10 \u2013 20%), lo\u1ea1i tr\u1eeb b\u1ec7nh nh\u00e2n m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Ngo\u00e0i ra, ARRIVE c\u0169ng \u0111\u00e1nh gi\u00e1 t\u00ednh an to\u00e0n c\u1ee7a aspirin. Nghi\u00ean c\u1ee9u bao g\u1ed3m t\u1ed5ng c\u1ed9ng 12,546 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ph\u00e2n ng\u1eabu nhi\u00ean v\u00e0o 2 nh\u00f3m aspirin v\u00e0 gi\u1ea3 d\u01b0\u1ee3c. Sau th\u1eddi gian theo d\u00f5i trung v\u1ecb l\u00e0 60 th\u00e1ng, ph\u00e2n t\u00edch intention \u2013 to \u2013 treat cho th\u1ea5y t\u1ef7 l\u1ec7 bi\u1ebfn c\u1ed1 tim m\u1ea1ch \u1edf nh\u00f3m aspirin l\u00e0 4.29%, t\u1ef7 l\u1ec7 n\u00e0y \u1edf nh\u00f3m gi\u1ea3 d\u01b0\u1ee3c l\u00e0 4.48% (kh\u00e1c bi\u1ec7t kh\u00f4ng c\u00f3 \u00fd ngh\u0129a). T\u1ef7 l\u1ec7 b\u1ec7nh nh\u00e2n b\u1ecb xu\u1ea5t huy\u1ebft d\u1ea1 d\u00e0y cao h\u01a1n c\u00f3 \u00fd ngh\u0129a \u1edf nh\u00f3m aspirin (0.97% vs 0.46%). T\u1ef7 l\u1ec7 c\u1ee7a c\u00e1c bi\u1ebfn c\u1ed1 c\u00f3 h\u1ea1i nghi\u00eam tr\u1ecdng t\u1ed5ng th\u1ec3 l\u00e0 t\u01b0\u01a1ng t\u1ef1 nhau gi\u1eefa 2 nh\u00f3m aspirin v\u00e0 gi\u1ea3 d\u01b0\u1ee3c. K\u1ebft qu\u1ea3 c\u1ee7a th\u1eed nghi\u1ec7m ARRIVE cho th\u1ea5y aspirin kh\u00f4ng c\u00f3 l\u1ee3i \u00edch trong ph\u00f2ng ng\u1eeba tim m\u1ea1ch ti\u00ean ph\u00e1t \u1edf b\u1ec7nh nh\u00e2n kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 nguy c\u01a1 trung b\u00ecnh, tuy nhi\u00ean l\u1ea1i l\u00e0m t\u0103ng \u0111\u00e1ng k\u1ec3 nguy c\u01a1 xu\u1ea5t huy\u1ebft [8]<\/sup>.<\/p>\n\n\n\n

Th\u1eed nghi\u1ec7m ASPREE \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh tr\u00ean ng\u01b0\u1eddi cao tu\u1ed5i kh\u1ecfe m\u1ea1nh (kh\u00f4ng m\u1eafc b\u1ec7nh tim m\u1ea1ch, kh\u00f4ng b\u1ecb sa s\u00fat tr\u00ed tu\u1ec7 ho\u1eb7c t\u00e0n t\u1eadt) \u1edf Australia v\u00e0 Hoa K\u1ef3. Nghi\u00ean c\u1ee9u bao g\u1ed3m 19,144 ng\u01b0\u1eddi tham gia nghi\u00ean c\u1ee9u. Sau 4.7 n\u0103m theo d\u00f5i, t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh tim m\u1ea1ch th\u1ea5p h\u01a1n \u1edf nh\u00f3m aspirin so v\u1edbi nh\u00f3m gi\u1ea3 d\u01b0\u1ee3c (kh\u00f4ng c\u00f3 \u00fd ngh\u0129a). T\u01b0\u01a1ng t\u1ef1 k\u1ebft qu\u1ea3 c\u1ee7a th\u1eed nghi\u1ec7m ASCEND v\u00e0 ARRIVE, t\u1ef7 l\u1ec7 b\u1ec7nh nh\u00e2n b\u1ecb xu\u1ea5t huy\u1ebft nghi\u00eam tr\u1ecdng cao h\u01a1n c\u00f3 \u00fd ngh\u0129a \u1edf nh\u00f3m aspirin so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c [9]<\/sup>. Nh\u01b0 v\u1eady, aspirin kh\u00f4ng c\u00f3 l\u1ee3i \u00edch gi\u1ea3m nguy c\u01a1 tim m\u1ea1ch nh\u01b0ng l\u1ea1i l\u00e0m t\u0103ng nguy c\u01a1 xu\u1ea5t huy\u1ebft \u1edf ng\u01b0\u1eddi cao tu\u1ed5i.<\/p>\n\n\n\n

Nh\u01b0 v\u1eady, nh\u00ecn chung aspirin ch\u1ec9 l\u00e0m gi\u1ea3m nguy c\u01a1 nh\u1ed3i m\u00e1u c\u01a1 tim kho\u1ea3ng 11% ng\u01b0ng l\u1ea1i l\u00e0m t\u0103ng \u0111\u1ebfn 58% nguy c\u01a1 xu\u1ea5t huy\u1ebft d\u1ea1 d\u00e0y v\u00e0 31% nguy c\u01a1 xu\u1ea5t huy\u1ebft n\u1ed9i s\u1ecd.<\/p>\n\n\n\n

Nhi\u1ec1u t\u1ed5 ch\u1ee9c quay l\u01b0ng v\u1edbi ch\u1ec9 \u0111\u1ecbnh ph\u00f2ng ng\u1eeba tim m\u1ea1ch ti\u00ean ph\u00e1t c\u1ee7a aspirin<\/strong><\/h2>\n\n\n\n

C\u00e1c b\u1eb1ng ch\u1ee9ng m\u1edbi v\u1ec1 l\u1ee3i \u00edch ph\u00f2ng ng\u1eeba ti\u00ean ph\u00e1t tim m\u1ea1ch c\u1ee7a aspirin \u0111\u00e3 d\u1eabn \u0111\u1ebfn nh\u1eefng thay \u0111\u1ed5i v\u1ec1 khuy\u1ebfn c\u00e1o ph\u00f2ng ng\u1eeba tim m\u1ea1ch ti\u00ean ph\u00e1t c\u1ee7a U.S. Preventive Services Task Force (USPSTF). C\u1ee5 th\u1ec3, USPSTF \u0111\u00e3 gi\u1ea3m m\u1ee9c \u0111\u1ed9 khuy\u1ebfn c\u00e1o li\u00ean quan \u0111\u1ebfn s\u1eed d\u1ee5ng aspirin trong ph\u00f2ng ng\u1eeba tim m\u1ea1ch ti\u00ean ph\u00e1t, tr\u01b0\u1edbc \u0111\u00e2y, USPSTF khuy\u1ebfn c\u00e1o \u201cn\u00ean\u201d kh\u1edfi \u0111\u1ea7u aspirin li\u1ec1u th\u1ea5p \u1edf ng\u01b0\u1eddi l\u1edbn 50 \u2013 59 tu\u1ed5i, tuy nhi\u00ean, khuy\u1ebfn c\u00e1o m\u1edbi c\u1eadp nh\u1eadt sau lo\u1ea1t b\u1eb1ng ch\u1ee9ng m\u1edbi \u0111\u00e3 gi\u1ea3m xu\u1ed1ng \u201cc\u00e2n nh\u1eafc\u201d kh\u1edfi \u0111\u1ea7u aspirin \u1edf ng\u01b0\u1eddi 40 \u2013 49 tu\u1ed5i c\u00f3 nguy c\u01a1 tim m\u1ea1ch > 10% [11]<\/sup>.<\/p>\n\n\n\n

B\u1ea3ng 1. <\/strong>Thay \u0111\u1ed5i trong ch\u1ec9 \u0111\u1ecbnh c\u1ee7a USPSTF 2022 v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng aspirin cho ch\u1ec9 \u0111\u1ecbnh ph\u00f2ng ng\u1eeba tim m\u1ea1ch ti\u00ean ph\u00e1t<\/p>\n\n\n\n

\"aspirin\"<\/figure>\n\n\n\n

T\u01b0\u01a1ng t\u1ef1, Vi\u1ec7n Tim m\u1ea1ch Hoa K\u1ef3 (American College of Cardiology) v\u00e0 Hi\u1ec7p h\u1ed9i Tim m\u1ea1ch Hoa K\u1ef3 (American Heart Association) c\u0169ng gi\u1ea3m m\u1ee9c \u0111\u1ed9 khuy\u1ebfn c\u00e1o k\u00ea \u0111\u01a1n aspirin trong ph\u00f2ng ng\u1eeba tim m\u1ea1ch ti\u00ean ph\u00e1t t\u1eeb \u201ckhuy\u1ebfn c\u00e1o m\u1ea1nh\u201d xu\u1ed1ng th\u00e0nh m\u1ed9t l\u1eddi tuy\u00ean b\u1ed1 kh\u00f4ng r\u00f5 r\u00e0ng \u201caspirin li\u1ec1u th\u1ea5p c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u0111\u1ec3 ph\u00f2ng ng\u1eeba tim m\u1ea1ch ti\u00ean ph\u00e1t \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n ch\u1ecdn l\u1ecdc t\u1eeb 40 \u2013 70 tu\u1ed5i\u201d [12]<\/sup>.<\/p>\n\n\n\n

Nhi\u1ec1u thu\u1ed1c m\u1edbi trong nh\u00f3m ch\u1ea5t \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 P2Y12 \u0111\u00e3 cho th\u1ea5y l\u1ee3i \u00edch l\u00e0m gi\u1ea3m bi\u1ebfn c\u1ed1 m\u1eafc nh\u1ed3i m\u00e1u c\u01a1 tim v\u00e0 \u0111\u1ed9t qu\u1ef5 \u1edf b\u1ec7nh nh\u00e2n m\u1eafc h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p nh\u01b0ng l\u1ea1i kh\u00e1 an to\u00e0n. Tuy nhi\u00ean, b\u1eb1ng ch\u1ee9ng v\u1ec1 c\u00e1c thu\u1ed1c nh\u00f3m \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 P2Y12 c\u0169ng ch\u1ec9 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh tr\u00ean b\u1ec7nh nh\u00e2n v\u1ed1n \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n m\u1eafc b\u1ec7nh tim m\u1ea1ch, n\u00ean hi\u1ec7u l\u1ef1c tr\u00ean ph\u00f2ng ng\u1eeba tim m\u1ea1ch ti\u00ean ph\u00e1t v\u1eabn c\u00f2n l\u00e0 m\u1ed9t \u1ea9n s\u1ed1. Hi\u1ec7n v\u1eabn ch\u01b0a c\u00f3 th\u1eed nghi\u1ec7m n\u00e0o v\u1ec1 c\u00e1c nh\u00f3m thu\u1ed1c n\u00e0y trong ph\u00f2ng ng\u1eeba bi\u1ebfn c\u1ed1 tim m\u1ea1ch ti\u00ean ph\u00e1t \u0111\u01b0\u1ee3c \u0111\u0103ng k\u00fd.<\/p>\n\n\n\n

B\u00e0n lu\u1eadn<\/strong><\/h2>\n\n\n\n

M\u1ed9t s\u1ed1 \u00fd ki\u1ebfn cho r\u1eb1ng \u1edf b\u1ec7nh nh\u00e2n > 60 tu\u1ed5i c\u00f3 nguy c\u01a1 tim m\u1ea1ch cao, kh\u00f4ng th\u1ec3 cai thu\u1ed1c l\u00e1, c\u00f3 nguy c\u01a1 xu\u1ea5t huy\u1ebft th\u1ea5p, aspirin c\u00f3 th\u1ec3 v\u1eabn l\u00e0 l\u1ef1a ch\u1ecdn ph\u00f2ng ng\u1eeba ti\u00ean ph\u00e1t ph\u00f9 h\u1ee3p [12]. Quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ng\u00e0y nay t\u1ed1t nh\u1ea5t l\u00e0 n\u00ean \u0111\u01b0\u1ee3c c\u00e1 nh\u00e2n h\u00f3a, do v\u1eady, \u0111\u1ed1i v\u1edbi t\u1eebng b\u1ec7nh nh\u00e2n, c\u1ea7n c\u00e2n nh\u1eafc gi\u1eefa l\u1ee3i \u00edch, nguy c\u01a1 v\u00e0 s\u1edf th\u00edch c\u1ee7a b\u1ec7nh nh\u00e2n khi \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb.<\/p>\n\n\n\n

\n\n\n\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/h3>\n\n\n\n
    \n
  1. Guirguis-Blake JM, Evans CV, Senger CA, O\u2019Connor EA, Whitlock EP. Aspirin for the primary prevention of cardiovascular events: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 2016; 164: 804\u201313.<\/li>\n\n\n\n
  2. Antithrombotic Trialists\u2019 (ATT) Collaboration. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 2009; 373: 1849\u201360.<\/li>\n\n\n\n
  3. Smith SC Jr, Benjamin EJ, Bonow RO, et al. World Heart Federation and the Preventive Cardiovascular Nurses Association. AHA\/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation 2011; 124: 2458\u201373.<\/li>\n\n\n\n
  4. Bibbins-Domingo K. Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2016; 164: 836\u201345.<\/li>\n\n\n\n
  5. Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37: 2315\u201381.<\/li>\n\n\n\n
  6. Peto R, Gray R, Collins R, et al. Randomised trial of prophylactic daily aspirin in British male doctors. Br Med J (Clin Res Ed) 1988; 296: 313\u201316.<\/li>\n\n\n\n
  7. Relman AS. Aspirin for the primary prevention of myocardial infarction. N Engl J Med. 1988 Jan 28;318(4):245-6. doi: 10.1056\/NEJM198801283180410.<\/li>\n\n\n\n
  8. ASCEND Study Collaborative Group; Bowman L, Mafham M, Wallendszus K, et al. Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. N Engl J Med. 2018 Oct 18;379(16):1529-1539. doi: 10.1056\/NEJMoa1804988.<\/li>\n\n\n\n
  9. McNeil JJ, Wolfe R, Woods RL, et al; ASPREE Investigator Group. Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. N Engl J Med. 2018 Oct 18;379(16):1509-1518. doi: 10.1056\/NEJMoa1805819.<\/li>\n\n\n\n
  10. Gaziano JM, Brotons C, Coppolecchia R, et al; ARRIVE Executive Committee. Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial. Lancet. 2018 Sep 22;392(10152):1036-1046. doi: 10.1016\/S0140-6736(18)31924-X.<\/li>\n\n\n\n
  11. US Preventive Services Task Force; Davidson KW, Barry MJ, Mangione CM, et al. Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement. JAMA. 2022 Apr 26;327(16):1577-1584. doi: 10.1001\/jama.2022.4983.<\/li>\n\n\n\n
  12. The Saga of Aspirin in Preventing Heart Disease – Medscape – April 24, 2024.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Vai tr\u00f2 c\u1ee7a aspirin trong \u1ee9c ch\u1ebf k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u v\u00e0 ph\u00f2ng ng\u1eeba th\u1ee9 ph\u00e1t c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh qua nhi\u1ec1u nghi\u00ean c\u1ee9u.<\/p>\n","protected":false},"author":123,"featured_media":35317,"comment_status":"closed","ping_status":"closed","template":"","meta":{"content-type":"","inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"default","ast-global-header-display":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"articles_categories":[1370],"articles_tags":[],"articles_topics":[1437],"articles_languages":[1375],"articles_filters":[],"class_list":["post-35302","articles","type-articles","status-publish","has-post-thumbnail","hentry","articles_categories-medical-content-vi","articles_languages-vietnamese-vi"],"_links":{"self":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/35302","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles"}],"about":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/types\/articles"}],"author":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/users\/123"}],"replies":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/comments?post=35302"}],"version-history":[{"count":0,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/35302\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media\/35317"}],"wp:attachment":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media?parent=35302"}],"wp:term":[{"taxonomy":"articles_categories","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_categories?post=35302"},{"taxonomy":"articles_tags","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_tags?post=35302"},{"taxonomy":"articles_topics","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_topics?post=35302"},{"taxonomy":"articles_languages","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_languages?post=35302"},{"taxonomy":"articles_filters","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_filters?post=35302"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}