Department of Neurology, 3rd Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
J Atheroscler Thromb. 2013;20(1):65-72. doi: 10.5551/jat.14092. Epub 2012 Aug 17.
Aspirin resistance (AR) is common in Chinese stroke patients taking antiplatelet medications; however, few studies have documented the role of cyclooxygenase (COX)-1 C50T and COX-2 G765C polymorphisms in AR. The aim of this study was to investigate the prevalence of AR in Chinese stroke patients and the relationships between AR and COX-1 C50T and COX-2 G765C polymorphisms, and to evaluate the effect of these polymorphisms on platelet response to aspirin.
We prospectively enrolled 634 Chinese stroke patients. Platelet aggregation testing was performed before and after aspirin administration. The pre- and post-aspirin levels of 11-dehydrothromboxane B(2) (11-dTxB(2)) were determined in urine samples. COX-1 C50T and COX-2 G765C genotypes were determined by a polymerase chain reaction-allelic restriction assay.
AR was detected in 129 patients (20.4%), aspirin semi-resistance (ASR) was detected in 28 patients (4.4%), and aspirin sensitivity (AS) was detected in 477 patients (75.2%). There was no association between COX-1 C50T or COX-2 G765C polymorphisms and ASR+AR. Aspirin could efficiently reduce 11-dTxB(2) production by approximately 75%. In addition, platelet aggregation, both in response to arachidonic acid (AA) and adenosine 5'-diphosphate (ADP), was inhibited by more than 80% and 40%, respectively; however, the percentage reduction in platelet aggregation and 11-dTxB(2) levels was not significantly different between the COX-1 C50T and COX-2 G765C genotypes (p>0.05).
There was no association between COX-1 C50T and COX-2 G765C polymorphisms and AR in Chinese stroke patients. In addition, COX-1 C50T and COX-2 G765C polymorphisms had no effect on the platelet response to aspirin.
阿司匹林抵抗(AR)在服用抗血小板药物的中国脑卒中患者中很常见;然而,很少有研究记录环氧化酶(COX)-1 C50T 和 COX-2 G765C 多态性在 AR 中的作用。本研究旨在调查中国脑卒中患者中 AR 的发生率以及 AR 与 COX-1 C50T 和 COX-2 G765C 多态性之间的关系,并评估这些多态性对血小板对阿司匹林反应的影响。
我们前瞻性地招募了 634 名中国脑卒中患者。在服用阿司匹林前后进行血小板聚集试验。尿样中测定 11-去氢血栓烷 B2(11-dTxB2)的预阿司匹林和后阿司匹林水平。通过聚合酶链反应-等位基因限制测定法确定 COX-1 C50T 和 COX-2 G765C 基因型。
在 129 名患者(20.4%)中检测到 AR,在 28 名患者(4.4%)中检测到阿司匹林半抵抗(ASR),在 477 名患者(75.2%)中检测到阿司匹林敏感(AS)。COX-1 C50T 或 COX-2 G765C 多态性与 ASR+AR 无关。阿司匹林可以有效地将 11-dTxB2 的产生减少约 75%。此外,血小板聚集,无论是对花生四烯酸(AA)还是腺苷 5'-二磷酸(ADP)的反应,均被抑制超过 80%和 40%;然而,血小板聚集和 11-dTxB2 水平的降低百分比在 COX-1 C50T 和 COX-2 G765C 基因型之间没有显著差异(p>0.05)。
在中国脑卒中患者中,COX-1 C50T 和 COX-2 G765C 多态性与 AR 无关。此外,COX-1 C50T 和 COX-2 G765C 多态性对血小板对阿司匹林的反应没有影响。