Department of Geriatrics, Peking University First Hospital, Peking University, Beijing, China (mainland).
Department of Clinical Laboratory Medicine, Peking University First Hospital, Peking University, Beijing, China (mainland).
Med Sci Monit. 2019 Jul 13;25:5191-5200. doi: 10.12659/MSM.917654.
BACKGROUND Aspirin hyporesponsiveness increases the risk of ischemic events. Therefore, it is important to investigate the factors influencing aspirin hyporesponsiveness. MATERIAL AND METHODS Patients aged 60 years or older who did not take aspirin before enrollment were included, with aspirin 100 mg/day administered after enrollment. The arachidonic acid-induced platelet aggregation rate (Ara) was measured by light transmission assay to evaluate aspirin responsiveness. Patients with Ara in the upper quartile after taking aspirin were assigned to the aspirin hyporesponsive group (Ara-Q4). RESULTS A total of 292 elderly patients were included. The median value of Ara after taking aspirin was 5.87% (interquartile range 3.86-10.04%). Compared with the aspirin non-hyporesponsive group (Ara-Q1-3, Ara ≤10.04%, n=220), the level of uric acid (UA) (341.30 µmol/L vs. 299.10 µmol/L, p=0.027) and the ratios of ß-blockers (9.72% vs. 2.27%, p=0.015) and diuretics (6.94% vs. 1.36%, p=0.036) were higher in the aspirin hyporesponsive group (Ara-Q4, Ara >10.04%, n=72). After multivariate adjustment, the results demonstrated baseline Ara (odds ratio [OR]: 1.030, 95% confidence interval [CI]: 1.004-1.056, p=0.021), UA level (OR: 1.003, 95% CI: 1.000-1.006, p=0.038), and ß-blockers use (OR: 5.487, 95% CI: 1.515-19.870, p=0.010) were independently and positively associated with aspirin hyporesponsiveness. CONCLUSIONS This study found that baseline Ara, UA level, and ß-blockers use were independently and positively associated with aspirin hyporesponsiveness in elderly Chinese patients, which needs to be validated in large-scale studies.
阿司匹林低反应性增加了缺血事件的风险。因此,研究影响阿司匹林低反应性的因素非常重要。
纳入年龄在 60 岁及以上且在入组前未服用阿司匹林的患者,入组后给予阿司匹林 100mg/天。通过透光比浊法测量花生四烯酸诱导的血小板聚集率(Ara),以评估阿司匹林的反应性。服用阿司匹林后 Ara 处于四分位上的患者被分配到阿司匹林低反应性组(Ara-Q4)。
共纳入 292 例老年患者。服用阿司匹林后 Ara 的中位数为 5.87%(四分位距 3.86-10.04%)。与阿司匹林非低反应性组(Ara-Q1-3,Ara≤10.04%,n=220)相比,阿司匹林低反应性组(Ara-Q4,Ara>10.04%,n=72)的尿酸(UA)水平(341.30µmol/L 比 299.10µmol/L,p=0.027)以及β受体阻滞剂(9.72%比 2.27%,p=0.015)和利尿剂(6.94%比 1.36%,p=0.036)的使用率更高。多变量调整后,结果显示基线 Ara(比值比 [OR]:1.030,95%置信区间 [CI]:1.004-1.056,p=0.021)、UA 水平(OR:1.003,95%CI:1.000-1.006,p=0.038)和β受体阻滞剂的使用(OR:5.487,95%CI:1.515-19.870,p=0.010)与阿司匹林低反应性独立且呈正相关。
本研究发现,基线 Ara、UA 水平和β受体阻滞剂的使用与中国老年患者的阿司匹林低反应性独立且呈正相关,这需要在大规模研究中进一步验证。