Chadha D S, Sumana Budha, Karthikeyan Ganesan, Jayaprasad V, Arun Shet S
MH (CTC), Pune, Maharashtra, India.
Hematology Research Division, St. Johns Research Institute, Bangalore, Karnataka, India.
Catheter Cardiovasc Interv. 2016 Oct;88(4):E126-E131. doi: 10.1002/ccd.25420. Epub 2015 Jan 23.
To evaluate the prevalence of pharmacological resistance to aspirin therapy by measuring platelet functions using the technique of light transmission aggregometry.
Aspirin is the cornerstone of antiplatelet therapy in patients with coronary artery disease (CAD). However, a substantial proportion of patients manifest breakthrough thrombotic events despite regular intake of aspirin suggesting therapeutic resistance to aspirin.
We prospectively studied 126 patients with stable coronary artery disease at a tertiary center, who were recruited after ensuring compliance with a single formulation of aspirin (enteric coated aspirin 150 mg). Platelet aggregation was measured using light transmission aggregometry with ADP (10 µM) and Arachidonic acid (0.5 mg/mL). Pharmacological aspirin resistance was defined as the combined demonstration of mean platelet aggregation of ≥70% with 10 µM ADP and a mean aggregation of ≥20% with 0.5 mg/mL A.A. Patients satisfying either one of the above criteria were defined as semi-responders. Patients satisfying neither criterion were defined as "aspirin responders".
Out of 126 patients with stable CAD, 64 % were responders, 36% were non responders (semi-responders = 34% and resistant = 2%). Of the laboratory parameters, only the total leukocyte count was significantly associated with the presence of aspirin resistance (P < 0.03).
Pharmacological resistance to aspirin is noted in 36% (semi-responders = 34% and resistant = 2%) of Asian Indian patients with stable CAD. Long-term follow up of these patients will assist in determining the clinical importance of this phenomenon. © 2014 Wiley Periodicals, Inc.
通过使用光透射聚集法测量血小板功能来评估阿司匹林治疗的药理学抵抗发生率。
阿司匹林是冠状动脉疾病（CAD）患者抗血小板治疗的基石。然而，相当一部分患者尽管规律服用阿司匹林仍出现突破性血栓事件，提示对阿司匹林存在治疗抵抗。
我们在一家三级中心对126例稳定型冠状动脉疾病患者进行了前瞻性研究，这些患者在确保遵守单一剂型阿司匹林（肠溶包衣阿司匹林150毫克）后被纳入研究。使用光透射聚集法，分别以10微摩尔/升二磷酸腺苷（ADP）和0.5毫克/毫升花生四烯酸（A.A.）检测血小板聚集情况。药理学阿司匹林抵抗定义为：10微摩尔/升ADP诱导的平均血小板聚集率≥70%且0.5毫克/毫升A.A.诱导的平均聚集率≥20%。满足上述任一标准的患者被定义为半反应者。不满足任何标准的患者被定义为“阿司匹林反应者”。
在126例稳定型CAD患者中，64%为反应者，36%为无反应者（半反应者 = 34%，抵抗者 = 2%）。在实验室参数中，只有白细胞总数与阿司匹林抵抗的存在显著相关（P < 0.03）。
在36%（半反应者 = 34%，抵抗者 = 2%）的亚洲印度裔稳定型CAD患者中发现了对阿司匹林的药理学抵抗。对这些患者进行长期随访将有助于确定这一现象的临床重要性。© 2014威利期刊公司
