Daily high-dose aspirin does not lower APRI in the Aspirin-Myocardial Infarction Study  

作　　者：Shilpa Tiwari-Heckler ZGordon Jiang Yury Popov Kenneth J.Mukamal 

机构地区：[1]Division of Gastroenterology and Hepatology,Department of Medicine,Harvard Medical School,Boston,MA 02115,USA [2]Division of General Medicine,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston,MA 02115,USA

出　　处：《The Journal of Biomedical Research》2020年第2期139-142,共4页生物医学研究杂志（英文版）

基　　金：supported by a German Research Foundation grant to STH(DFG TI 988/1-1);NIH grant to ZGJ(K08DK115883)a Clinical Research Award from ACG and an Alan Hoffman Clinical and Translational Research Award from AASLD to ZGJ。

摘　　要：Antiplatelet agents reduce liver fibrosis by inhibiting platelet activation and platelet-derived growth factor production. Previous cross-sectional epidemiological studies suggest that the use of aspirin is related to reduced liver fibrosis. The Aspirin-Myocardial Infarction Study(AMIS) aims to examine this relationship in a multicenter,randomized, double-blind and placebo-controlled trial. The existing clinical trial of aspirin was conducted to study the benefit of one gram aspirin daily among 4 524 individuals who had experienced at least one documented myocardial infarction. The aspartate aminotransferase(AST)-to-Platelet Ratio Index(APRI) was calculated at baseline and annually from the platelet count and AST levels. Participants in the AMIS trial had a mean baseline APRI of 0.34±0.36, and only 1% individuals had APRI scores higher than 1.0, a common cutoff for cirrhosis. The daily use of aspirin was associated with an increase, rather than a reduction of APRI, by 0.007 per year(95% CI0.002-0.015, P=0.12). The use of aspirin did not significantly affect platelet counts. In a sensitivity analysis of individuals with probable significant fibrosis at baseline(APRI≥0.7), the aspirin group had a sustained reduction in APRI over time, although this change was not significant compared to that in the placebo group. In the AMIS trial, the daily use of high-dose aspirin did not significantly affect APRI, a surrogate index of liver fibrosis. This study highlights the need for de novo clinical trials to investigate the potential benefit of antiplatelet agents on liver fibrosis.

关 键 词：liver fibrosis ASPIRIN APRI ANTIPLATELET AMIS 

分 类 号：R575.2[医药卫生—消化系统] R542.22[医药卫生—内科学]