阿司匹林抵抗：现状与个体化治疗的作用。
Aspirin resistance: current status and role of tailored therapy.
机构信息
Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
出版信息
Clin Cardiol. 2012 Nov;35(11):673-81. doi: 10.1002/clc.22031. Epub 2012 Jun 27.
Abstract
Aspirin is integral in the primary and secondary prevention of coronary artery disease and acute coronary syndrome. Given the high clinical importance of aspirin in the management of coronary artery disease, much attention has been directed towards the concept of "aspirin resistance." Unfortunately, the term aspirin resistance is ill-defined in the literature, leading to a large variance in the reported prevalence of this phenomenon. In this review, the current understanding of aspirin resistance is discussed. Commonly used functional and diagnostic tests of platelet function, including their strengths and weakness, are reviewed. We next discuss several proposed mechanisms of aspirin resistance and special high-risk groups at risk for aspirin treatment failure. We then discuss optimal dosing and diagnostic strategies for those populations at risk for aspirin resistance with a focus on tailored aspirin therapy for high-risk groups. Finally, future topics of interest in the field of aspirin resistance are considered.
摘要
阿司匹林在冠状动脉疾病和急性冠脉综合征的一级和二级预防中不可或缺。鉴于阿司匹林在冠状动脉疾病管理中的重要临床意义，人们对“阿司匹林抵抗”这一概念给予了高度关注。不幸的是，文献中阿司匹林抵抗的定义不明确，导致这一现象的报告发生率差异很大。在这篇综述中，讨论了目前对阿司匹林抵抗的认识。综述了血小板功能的常用功能和诊断检测方法，包括它们的优缺点。接下来，我们讨论了几种提出的阿司匹林抵抗机制和特殊的高危人群，这些人群有发生阿司匹林治疗失败的风险。然后，我们讨论了有发生阿司匹林抵抗风险的人群的最佳剂量和诊断策略，重点是针对高危人群的个体化阿司匹林治疗。最后，考虑了阿司匹林抵抗领域未来的研究课题。
相似文献
1
Aspirin resistance: current status and role of tailored therapy.阿司匹林抵抗：现状与个体化治疗的作用。
Clin Cardiol. 2012 Nov;35(11):673-81. doi: 10.1002/clc.22031. Epub 2012 Jun 27.
2
Why an aspirin a day no longer keeps the doctor away ….为何每天服用一片阿司匹林不再能让你远离医生……
Thromb Haemost. 2011 Feb;105(2):209-10. doi: 10.1160/TH10-11-0749. Epub 2010 Dec 6.
3
Adrenoreceptors, platelet reactivity and clopidogrel resistance.肾上腺素能受体、血小板反应性与氯吡格雷抵抗
Thromb Haemost. 2008 Nov;100(5):729-30.
4
Dose-related effect of aspirin on laboratory-defined platelet aggregation and clinical outcome after coronary stenting.阿司匹林剂量与冠状动脉支架置入术后实验室定义的血小板聚集和临床结局的相关性。
Cardiovasc Ther. 2010 Jun;28(3):147-52. doi: 10.1111/j.1755-5922.2010.00170.x.
5
Antiplatelet effect of aspirin in patients with coronary artery disease.阿司匹林对冠状动脉疾病患者的抗血小板作用。
Dan Med J. 2012 Sep;59(9):B4506.
6
24-hour time-dependent aspirin efficacy in patients with stable coronary artery disease.稳定性冠心病患者的 24 小时时间依赖性阿司匹林疗效。
Thromb Haemost. 2011 Feb;105(2):336-44. doi: 10.1160/TH10-02-0082. Epub 2010 Dec 7.
7
Aspirin-resistant platelet aggregation in a cohort of patients with coronary heart disease.一组冠心病患者中的阿司匹林抵抗性血小板聚集
Blood Coagul Fibrinolysis. 2007 Jul;18(5):461-5. doi: 10.1097/MBC.0b013e32814db7e7.
8
Reduced antiplatelet effect of aspirin is associated with low-grade inflammation in patients with coronary artery disease.阿司匹林抗血小板作用降低与冠心病患者的低度炎症有关。
Thromb Haemost. 2013 May;109(5):920-9. doi: 10.1160/TH12-09-0666. Epub 2013 Feb 14.
9
Aspirin resistance: is it real? Is it clinically significant?阿司匹林抵抗：它真的存在吗？它具有临床意义吗？
Am J Med. 2007 Jan;120(1):1-4. doi: 10.1016/j.amjmed.2006.08.023.
10
Reduced Antiplatelet Effect of Aspirin Does Not Predict Cardiovascular Events in Patients With Stable Coronary Artery Disease.阿司匹林抗血小板作用降低并不能预测稳定型冠状动脉疾病患者的心血管事件。
J Am Heart Assoc. 2017 Aug 5;6(8):e006050. doi: 10.1161/JAHA.117.006050.
引用本文的文献
1
Nanoparticles For Rescue: Innovative Therapeutic Strategy For Cardiac Repair After Myocardial Infarction.纳米粒子助力救援：心肌梗死后心脏修复的创新治疗策略
J Cardiovasc Transl Res. 2025 Jul 18. doi: 10.1007/s12265-025-10660-9.
2
Utility of the US Preventive Services Task Force for Preeclampsia Risk Assessment and Aspirin Prophylaxis.美国预防服务工作组在子痫前期风险评估和阿司匹林预防中的作用。
JAMA Netw Open. 2025 Jul 1;8(7):e2521792. doi: 10.1001/jamanetworkopen.2025.21792.
3
Early detection of resistance to dual antiplatelet therapy in patients who have undergone percutaneous coronary intervention using the VerifyNow test and associated factors.使用VerifyNow检测对接受经皮冠状动脉介入治疗患者的双重抗血小板治疗耐药性的早期检测及相关因素。
Med Int (Lond). 2024 Jul 18;4(6):56. doi: 10.3892/mi.2024.180. eCollection 2024 Nov-Dec.
4
Pharmacogenomics of Cardiovascular Drugs for Atherothrombotic, Thromboembolic and Atherosclerotic Risk.心血管药物的药物基因组学与动脉粥样硬化血栓形成、血栓栓塞和动脉粥样硬化风险
Genes (Basel). 2023 Nov 9;14(11):2057. doi: 10.3390/genes14112057.
5
Genetic Association Study and Machine Learning to Investigate Differences in Platelet Reactivity in Patients with Acute Ischemic Stroke Treated with Aspirin.基因关联研究与机器学习用于调查阿司匹林治疗的急性缺血性中风患者血小板反应性的差异
Biomedicines. 2022 Oct 13;10(10):2564. doi: 10.3390/biomedicines10102564.
6
Current and Future Insights for Optimizing Antithrombotic Therapy to Reduce the Burden of Cardiovascular Ischemic Events in Patients with Acute Coronary Syndrome.优化抗栓治疗以减轻急性冠状动脉综合征患者心血管缺血事件负担的当前及未来见解
J Clin Med. 2022 Sep 23;11(19):5605. doi: 10.3390/jcm11195605.
7
Aspirin Colorectal Cancer Prevention in Lynch Syndrome: Recommendations in the Era of Precision Medicine.阿司匹林在林奇综合征结直肠癌预防中的应用：精准医学时代的建议。
Genes (Basel). 2022 Mar 3;13(3):460. doi: 10.3390/genes13030460.
8
Mechanism of Improving Aspirin Resistance: Blood-Activating Herbs Combined With Aspirin in Treating Atherosclerotic Cardiovascular Diseases.改善阿司匹林抵抗的机制：活血化瘀中药联合阿司匹林治疗动脉粥样硬化性心血管疾病
Front Pharmacol. 2021 Dec 17;12:794417. doi: 10.3389/fphar.2021.794417. eCollection 2021.
9
The dilemma of aspirin resistance in obese patients.肥胖患者阿司匹林抵抗的困境。
Ann Transl Med. 2019 Sep;7(17):404. doi: 10.21037/atm.2019.07.52.
10
Effect of Sociodemographic Variables and Other Factors on the Usage of Different Doses of Aspirin in Postmyocardial Infarction Patients: A Cross-sectional Study.社会人口学变量及其他因素对心肌梗死后患者不同剂量阿司匹林使用情况的影响：一项横断面研究
Heart Views. 2018 Apr-Jun;19(2):49-53. doi: 10.4103/1995-705X.244187.
本文引用的文献
1
Platelet response to aspirin 50 and 100 mg in patients with coronary heart disease over a five-year period.在五年期间，冠心病患者对阿司匹林 50 毫克和 100 毫克的血小板反应。
Am J Cardiol. 2011 Sep 1;108(5):644-50. doi: 10.1016/j.amjcard.2011.04.011. Epub 2011 Jun 20.
2
Aspirin resistance in off-pump coronary artery bypass grafting.非体外循环冠状动脉旁路移植术中的阿司匹林抵抗。
Eur J Cardiothorac Surg. 2012 Jan;41(1):108-12. doi: 10.1016/j.ejcts.2011.04.021.
3
Standard- vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial.基于经皮冠状动脉介入治疗后血小板功能检测的标准剂量与高剂量氯吡格雷：GRAVITAS 随机试验。
JAMA. 2011 Mar 16;305(11):1097-105. doi: 10.1001/jama.2011.290.
4
Pharmacodynamic effects of different aspirin dosing regimens in type 2 diabetes mellitus patients with coronary artery disease.不同剂量阿司匹林方案对伴有冠状动脉疾病的 2 型糖尿病患者的药效学影响。
Circ Cardiovasc Interv. 2011 Apr 1;4(2):180-7. doi: 10.1161/CIRCINTERVENTIONS.110.960187. Epub 2011 Mar 8.
5
Aspirin resistance: effect of clinical, biochemical and genetic factors.阿司匹林抵抗：临床、生化和遗传因素的影响。
Pharmacol Ther. 2011 May;130(2):213-25. doi: 10.1016/j.pharmthera.2011.01.011. Epub 2011 Feb 2.
6
Overview of the 2010 Food and Drug Administration Cardiovascular and Renal Drugs Advisory Committee meeting regarding ticagrelor.2010年美国食品药品监督管理局心血管和肾脏药物咨询委员会关于替格瑞洛的会议概述。
Circulation. 2011 Feb 1;123(4):451-6. doi: 10.1161/CIRCULATIONAHA.110.985325. Epub 2011 Jan 17.
7
8
24-hour time-dependent aspirin efficacy in patients with stable coronary artery disease.稳定性冠心病患者的 24 小时时间依赖性阿司匹林疗效。
Thromb Haemost. 2011 Feb;105(2):336-44. doi: 10.1160/TH10-02-0082. Epub 2010 Dec 7.
9
Dose comparisons of clopidogrel and aspirin in acute coronary syndromes.氯吡格雷和阿司匹林在急性冠脉综合征中的剂量比较。
N Engl J Med. 2010 Sep 2;363(10):930-42. doi: 10.1056/NEJMoa0909475.
10
Patients with previous definite stent thrombosis have a reduced antiplatelet effect of aspirin and a larger fraction of immature platelets.既往明确支架血栓形成的患者阿司匹林抗血小板作用减弱，血小板未成熟比例增大。
JACC Cardiovasc Interv. 2010 Aug;3(8):828-35. doi: 10.1016/j.jcin.2010.05.014.
Zotero 插件