Prevalence of aspirin resistance measured by PFA-100

被引:44
作者
Coma-Canella, I [1 ]
Velasco, A [1 ]
Castano, S [1 ]
机构
[1] Univ Navarra Clin, Dept Cardiol & Cardiovasc Surg, Fac Med, Pamplona 31008, Spain
关键词
aspirin; platelet function analyzer (PFA-100); epinephrine closure time;
D O I
10.1016/j.ijcard.2004.03.069
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Aspirin protects from cardiovascular events. However, a number of patients who take this drug suffer events, probably due to aspirin resistance. Our objective was to determine the prevalence of aspirin resistance in patients taking this drug and to test if resistance is related to different variables. Methods: Platelet function was studied in 113 patients (90 men) aged 63 9 (80 with stable ischaemic heart disease) who took aspirin (100 to 300 mg/day). By a platelet function analyzer, called PFA-100, the epinephrine closure time was studied. We also analysed the possible relationship between epinephrine closure time and the following variables: total cholesterol, LDL, HDL cholesterol, total/HDL cholesterol, triglycerides, lipoprotein(a), and C reactive protein. The possible association between aspirin resistance (epinephrine closure time < 161 s) and different variables was also analyzed with the SPSS statistical package. Results are expressed in median (interquartile range). Results: Aspirin resistance was found in 32% of cases. Ischaemic heart disease, smoking habit, and treatment with statins were associated with a significantly greater percent of resistance (p=0.049, 0.009, and 0.043, respectively). Patients with aspirin resistance had higher levels of total/HDL cholesterol: 4.46 (3.76-5.55) vs. 3.97 (3.20-4.75) (p=0.023); and lipoprotein(a): 57.2 (24.8-85.0) mg/dl vs. 13.1 (3.7-38.0) mg/dl (p=0.007). Conclusions: Aspirin resistance is frequent and easily detected by PFA-100. It occurs more frequently in smokers. A mild association is found with ischaemic heart disease, some lipids, and treatment with statins. Our results support the applicability of this method to clinical practice. (c) 2004 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:71 / 76
页数:6
相关论文
共 35 条
[21]   Low high-density lipoprotein cholesterol - Physiological background, clinical importance and drug treatment [J].
Hersberger, M ;
von Eckardstein, A .
DRUGS, 2003, 63 (18) :1907-1945
[22]   CIGARETTE-SMOKING ACUTELY INCREASES PLATELET THROMBUS FORMATION IN PATIENTS WITH CORONARY-ARTERY DISEASE TAKING ASPIRIN [J].
HUNG, J ;
LAM, JYT ;
LACOSTE, L ;
LETCHACOVSKI, G .
CIRCULATION, 1995, 92 (09) :2432-2436
[23]  
Jilma B, 2001, AM J CARDIOL, V88, P1348
[24]   Increased platelet sensitivity to collagen in individuals resistant to low-dose aspirin [J].
Kawasaki, T ;
Ozeki, Y ;
Igawa, T ;
Kambayashi, J .
STROKE, 2000, 31 (03) :591-595
[25]   Resistance in vitro to low-dose aspirin is associated with platelet PlA1 (GP IIIa) polymorphism but not with C807T (GP Ia/IIa) and C-5T Kozak (GP Ibα) polymorphisms [J].
Macchi, L ;
Christiaens, L ;
Brabant, S ;
Sorel, N ;
Ragot, S ;
Allal, J ;
Mauco, G ;
Brizard, A .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2003, 42 (06) :1115-1119
[26]   Resistance to aspirin in vitro is associated with increased platelet sensitivity to adenosine diphosphate [J].
Macchi, L ;
Christiaens, L ;
Brabant, S ;
Sorel, N ;
Allal, J ;
Mauco, G ;
Brizard, A .
THROMBOSIS RESEARCH, 2002, 107 (1-2) :45-49
[27]  
Mueller MR, 1997, THROMB HAEMOSTASIS, V78, P1003
[28]   In vitro bleeding test with PFA-100™ - Aspects of controlling individual acetylsalicylic acid induced platelet inhibition in patients with cardiovascular disease [J].
Peters A.J. ;
Borries M. ;
Gradaus F. ;
Jax T.W. ;
Schoebel F.C. ;
Strauer B.E. .
Journal of Thrombosis and Thrombolysis, 2001, 12 (3) :263-272
[29]   Aspirin resistance in patients with acute myocardial infarction: is it of any clinical importance? [J].
Poulsen, T ;
Mickley, H ;
Licht, P ;
Haghfelt, T ;
Jorgensen, B .
EUROPEAN HEART JOURNAL, 2003, 24 :371-371
[30]  
Puccetti L, 2001, NUTR METAB CARDIOVAS, V11, P378