Forood Afsaneh, Malekpour-Afshar Reza, Sarnevesht Jamshid
Assistant Professor, Department of Cardiology AND Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Associate Professor, Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Addict Health. 2014 Winter;6(1-2):7-13.
The rate of cardiovascular diseases in developing countries is approximately 60% and it is still has an increasing trend. The clinical effectiveness of aspirin in preventing cardiovascular events has been well proven. Although aspirin is an effective and inexpensive drug, its consumption is not equally beneficial for all patients. Many factors can be affective on the efficacy of antiplatelet drugs such as aspirin.
This study was carried out on 260 patients who had stable angina pectoris and coronary artery disease was approved by coronary angiography. Based on opium addiction, the patients were divided into two groups. Opium addiction was diagnosed base on Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. The mid-stream morning urinary sample were collected for measuring the urinary 11-dehydroxy thromboxane B2 level (UTXB2). Urinary level of UTXB2 was considered as an aspirin resistance index.
The mean age of patients was 57.3 ± 8.9; and 44.6% of them were females. The aspirin resistance rate was 41.5%. Significant difference in aspirin resistance was observed between the opium addicts and non-addicts. (51.5% vs. 31.5%) (P = 0.001). The effects of confounding variables such as diabetes, hypertension, and hyperlipidemia were eliminated by regression logistic multivariable analysis.
The prevalence of aspirin resistance in patients with stable angina pectoris was 41.5%. The prevalence of aspirin resistance in patients with stable angina pectoris who had opium addiction was significantly higher them non-addicts.
发展中国家心血管疾病的发病率约为60%,且仍呈上升趋势。阿司匹林预防心血管事件的临床有效性已得到充分证实。尽管阿司匹林是一种有效且廉价的药物,但其对所有患者的疗效并不相同。许多因素会影响抗血小板药物如阿司匹林的疗效。
本研究对260例经冠状动脉造影证实患有稳定型心绞痛和冠状动脉疾病的患者进行。根据是否有阿片类药物成瘾,将患者分为两组。阿片类药物成瘾根据《精神疾病诊断与统计手册》第四版(DSM-IV)标准进行诊断。收集清晨中段尿样本以测量尿11-脱氢血栓素B2水平(UTXB2)。UTXB2的尿水平被视为阿司匹林抵抗指数。
患者的平均年龄为57.3±8.9岁;其中44.6%为女性。阿司匹林抵抗率为41.5%。在阿片类药物成瘾者和非成瘾者之间观察到阿司匹林抵抗存在显著差异。(51.5%对31.5%)(P=0.001)。通过多变量逻辑回归分析消除了糖尿病、高血压和高脂血症等混杂变量的影响。
稳定型心绞痛患者中阿司匹林抵抗的患病率为41.5%。有阿片类药物成瘾的稳定型心绞痛患者中阿司匹林抵抗的患病率显著高于非成瘾者。