Pusch Gabriella, Feher Gergely, Kotai Katalin, Tibold Antal, Gasztonyi Beata, Feher Andrea, Papp Elod, Lupkovics Geza, Szapary Laszlo
Department of Neurology, University of Pecs, School of Medicine, Pecs, Hungary.
J Cardiovasc Pharmacol. 2008 Dec;52(6):475-84. doi: 10.1097/FJC.0b013e31818eee5f.
Via its antiplatelet effect, aspirin reduces the odds of an arterial thrombotic event in high-risk patients by approximately 25%. However, 10% to 20% of patients with an arterial thrombotic event who are treated with aspirin have a recurrent arterial thrombotic event during long-term follow-up. Nevertheless, the effectiveness of aspirin has been questioned by the emergence of the concept of aspirin resistance, which has been introduced as an explanation of the fact that a considerable proportion of patients treated with aspirin exhibit normal platelet function.
We systematically reviewed all available evidence till March 2008 on prevalence of aspirin resistance and its association with clinical outcome. We also collected articles showing the possible way of treatment.
Analyzing the data of different laboratory methods aspirin resistance seems to be associated with poor clinical outcome, although currently no standardized or widely accepted definition of aspirin resistance exists. The widely used laboratory methods might not be comparable with each other; therefore, specific treatment recommendations for patients who exhibit high platelet reactivity during aspirin therapy or who have poor platelet inhibition by aspirin are not established.
阿司匹林通过其抗血小板作用,可使高危患者发生动脉血栓事件的几率降低约25%。然而,接受阿司匹林治疗的动脉血栓事件患者中有10%至20%在长期随访期间会发生复发性动脉血栓事件。尽管如此,阿司匹林抵抗概念的出现对阿司匹林的有效性提出了质疑,引入这一概念是为了解释相当一部分接受阿司匹林治疗的患者表现出正常血小板功能这一事实。
我们系统回顾了截至2008年3月所有关于阿司匹林抵抗患病率及其与临床结局关联的现有证据。我们还收集了展示可能治疗方法的文章。
分析不同实验室方法的数据发现,阿司匹林抵抗似乎与不良临床结局相关,尽管目前尚无阿司匹林抵抗的标准化或广泛接受的定义。广泛使用的实验室方法可能彼此不可比;因此,对于阿司匹林治疗期间血小板反应性高或阿司匹林对血小板抑制作用差的患者,尚未制定具体的治疗建议。