Kuliczkowski Wiktor, Halawa Bogumił, Korolko Bozena, Mazurek Walentyna
Department of Cardiology, Medical Academy, Wrocław, Poland.
Kardiol Pol. 2005 Jan;62(1):14-25.
In spite of the usage of acetylsalicylic acid (aspirin) in the secondary prevention of ischaemic heart disease (IHD), new thrombo-embolic events occur in more than half of patients. Aspirin resistance may be partially responsible for this phenomenon.
To assess the prevalence of aspirin resistance in patients with IHD and to correlate this phenomenon with the progression of atherosclerosis, concomitant diseases and other medication.
The study group consisted of 205 patients (mean age 65.8 years, 95 females) with stable angina, recent coronary angiography and positive result of non-invasive stress tests, treated with 75 mg of aspirin for at least one week. Platelet aggregation was measured using the optical aggregation method. Aspirin resistance was defined as a mean collagen and ATP-induced platelet aggregation >70%.
Aspirin resistance was found in 41 (20%) patients and was significantly associated with previous coronary artery bypass grafting (CABG) (p<0.01) and three-vessel disease (p<0.05). Previous CABG was the only independent risk factor for the presence of aspirin resistance (OR 5.6; 95% CI 2.0-15.4; p<0.01).
Aspirin resistance is present in 20% of patients with stable angina. Previous CABG is an independent risk factor of this phenomenon.
尽管使用乙酰水杨酸（阿司匹林）进行缺血性心脏病（IHD）的二级预防，但仍有超过半数的患者发生新的血栓栓塞事件。阿司匹林抵抗可能是导致这一现象的部分原因。
评估IHD患者中阿司匹林抵抗的发生率，并将这一现象与动脉粥样硬化进展、伴发疾病及其他药物治疗相关联。
研究组由205例患者（平均年龄65.8岁，女性95例）组成，这些患者患有稳定型心绞痛，近期接受过冠状动脉造影且无创负荷试验结果呈阳性，服用75毫克阿司匹林至少一周。采用光学聚集法测量血小板聚集。阿司匹林抵抗定义为胶原和ATP诱导的平均血小板聚集率>70%。
41例（20%）患者存在阿司匹林抵抗，且与既往冠状动脉旁路移植术（CABG）（p<0.01）和三支血管病变（p<0.05）显著相关。既往CABG是阿司匹林抵抗存在的唯一独立危险因素（OR 5.6；95%CI 2.0 - 15.4；p<0.01）。
20%的稳定型心绞痛患者存在阿司匹林抵抗。既往CABG是这一现象的独立危险因素。
