Teragawa Hiroki, Mitsuba Naoya, Ishibashi Ken, Kurisu Satoshi, Kihara Yasuki
Hiroki Teragawa, Department of Cardiovascular Medicine, Hiroshima General Hospital of West Japan Railway Company, Hiroshima 732-0057, Japan.
World J Cardiol. 2013 Nov 26;5(11):426-33. doi: 10.4330/wjc.v5.i11.426.
To investigate the effects of different doses of aspirin on coronary endothelial function.
The study included 139 Japanese subjects (mean age, 60 years; 53 women) with angiographically normal coronary arteries. Patients were distributed into Group I (n = 63), who was administered aspirin and Group II (n = 76), the control, who were not administered aspirin. Group I was further divided into Group Ia (n = 50, low-dose aspirin, 100 mg) and Group Ib (n = 13, high-dose aspirin, 500 mg). After a routine coronary angiography, acetylcholine (ACh; 3 and 30 μg/min successively) and nitroglycerin (NTG) were infused into the left coronary ostium over 2 min. The change in the diameter of the coronary artery in response to each drug was expressed as the percentage change from baseline values.
The patient characteristics did not differ between the two groups. The change in coronary diameter in response to ACh was greater in Group I than in Group II (P = 0.0043), although the NTG-induced coronary vasodilation was similar between groups. ACh-induced dilation was greater in Group Ia than in Group Ib (P = 0.0231). Multivariate regression analysis showed that a low-dose of aspirin (P = 0.0004) was one of the factors associated with ACh-induced dilation at 30 μg/min.
In subjects with angiographically normal coronary arteries, aspirin only had a positive influence on coronary endothelial function at the low dose of 100 mg. This improvement of coronary endothelial function may be involved in the preventive effect of aspirin against future coronary events.
研究不同剂量阿司匹林对冠状动脉内皮功能的影响。
该研究纳入了139名冠状动脉造影显示正常的日本受试者(平均年龄60岁;53名女性)。患者被分为两组,第一组(n = 63)服用阿司匹林,第二组(n = 76)作为对照组,不服用阿司匹林。第一组又进一步分为Ia组(n = 50,低剂量阿司匹林,100毫克)和Ib组(n = 13,高剂量阿司匹林,500毫克)。在进行常规冠状动脉造影后,在2分钟内将乙酰胆碱(ACh;先后为3和30微克/分钟)和硝酸甘油(NTG)注入左冠状动脉口。冠状动脉直径对每种药物的反应变化以相对于基线值的百分比变化表示。
两组患者的特征无差异。第一组对ACh的冠状动脉直径变化大于第二组(P = 0.0043),尽管两组间NTG诱导的冠状动脉血管舒张相似。Ia组中ACh诱导的扩张大于Ib组(P = 0.0231)。多变量回归分析表明,低剂量阿司匹林(P = 0.0004)是与30微克/分钟时ACh诱导的扩张相关的因素之一。
在冠状动脉造影正常的受试者中,阿司匹林仅在100毫克的低剂量时对冠状动脉内皮功能有积极影响。冠状动脉内皮功能的这种改善可能与阿司匹林对未来冠状动脉事件的预防作用有关。