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심뇌혈관질환 예방을 위한 아스피린의 근거중심 사용법

Aspirin Usage Based on Evidence for the Prevention of Cardio-Cerebrovascular Disease

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참고문헌

키워드

주제분류가정의학

초록

아스피린은 심뇌혈관질환 예방에 사용하는 항 혈소판제 중 가장 중추적인 역할을 하는 약제이지만, 긍정적 효과 이외 에 위장관계 합병증이나 뇌출혈 등의 부작용이 적지 않다. 특 히, 한국인에서는 헬리코박터균 감염률이 높고, 뇌혈관질환 중 뇌출혈이 차지하는 비중이 매우 크기 때문에 그 사용에 있 어 보다 신중해야 할 것이다. 현재 심뇌혈관질환의 이차예방 에 대해서는 확립된 지침이 있지만, 일차예방에 대해서는 아 직도 논란이 많다. 본 고에서는 지금까지 발표된 아스피린의 심뇌혈관질환 예방에 대한 효과를 검토하고 아스피린을 사용 할 때 고려해야 할 몇 가지 사항들을 고찰함으로써 실제 임상 에서 아스피린의 현명한 사용에 도움이 되고자 한다.

Abstract

Aspirin is well known for its central role in preventing cardio cerebrovascular diseases as an antiplatelet agent. However besides its favorable effects, one must also be fully aware of its side effects such as gastrointestinal complications or cerebral hemorrhage. Particularly when prescribing to Koreans, one must be highly cautious, considering the higher prevalence of helicobacter pylori infection and the contribution of hemorrhagic stroke as a major part of cerebral disease in Korean. Currently the guideline for secondary prevention of cardio cerebrovascular diseases is relatively well established, while the consensus for primary prevention is still controversial. The purpose of this paper would be to summarize the evidence of aspirin usage in preventing cardio cerebrovascular diseases, examine the additional factors one must consider, and help primary physician prescribing aspirin appropriately.

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