Mustafa Cetin, MD, Department of Cardiology, Ankara Numune Education and Research Hospital, Talatpasa Bulvari, 06100, Sihhiye, Ankara, Turkey.
Emrullah Kiziltunc, MD, Department of Cardiology, Ankara Numune Education and Research Hospital, Talatpasa Bulvari, 06100, Sihhiye, Ankara, Turkey.
Pak J Med Sci. 2014 May;30(3):539-44. doi: 10.12669/pjms.303.4773.
Objective : Several studies have demonstrated the beneficial role of antiplatelet therapy with acetylsalicylic acid (ASA) at atherosclerotic vascular disease. Antiaggregant effect of ASA is not uniform in all patients. Purpose of the present study is to evaluate the prevalence of ASA resistance in patients with type 2 diabetes mellitus (T2DM), pre-diabetes and non-diabetic coronary artery disease (CAD).
Effect of ASA was assessed using the platelet function analyzer (PFA-100) system. Resistance to ASA was defined as a normal collagen/epinephrine induced closure time after one week of ASA therapy. Patients with non-diabetic CAD, pre-diabetes and T2DM were compared.
ASA resistance was found in 26 (37.1%), 6 (17.6%) and 41 (26.5%) patients in the groups, respectively (p=0.154). ASA resistance was found to be significantly higher in men, smokers and insulin users, besides this it was found to be significantly lower in beta blocker (BB) users, angiotensin converting enzyme inhibitor (ACEI) users with univariate analysis. However insulin usage was found to be the single effective parameter on ASA resistance in multivariate analysis.
There was no difference with regard to ASA resistance between groups. While ASA resistance was higher in men, smokers and insulin users, it was lower in patients using BBs and ACEIs.
几项研究已经证明了抗血小板治疗用乙酰水杨酸(ASA)在动脉粥样硬化血管疾病中的有益作用。ASA 的抗聚集作用并非在所有患者中都均匀。本研究的目的是评估 2 型糖尿病(T2DM)、糖尿病前期和非糖尿病性冠心病(CAD)患者中 ASA 抵抗的发生率。
使用血小板功能分析仪(PFA-100)系统评估 ASA 的作用。ASA 抵抗定义为在 ASA 治疗一周后正常胶原/肾上腺素诱导的闭合时间。比较了非糖尿病性 CAD、糖尿病前期和 T2DM 患者。
ASA 抵抗分别在组中的 26(37.1%)、6(17.6%)和 41(26.5%)患者中发现(p=0.154)。ASA 抵抗在男性、吸烟者和胰岛素使用者中明显更高,此外,在单变量分析中,β受体阻滞剂(BB)使用者、血管紧张素转换酶抑制剂(ACEI)使用者中发现其明显较低。然而,胰岛素的使用是多变量分析中唯一有效的 ASA 抵抗参数。
各组之间在 ASA 抵抗方面没有差异。虽然 ASA 抵抗在男性、吸烟者和胰岛素使用者中更高,但在使用 BB 和 ACEI 的患者中较低。