Ebrahimi Parvin, Farhadi Zeynab, Behzadifar Masoud, Shabaninejad Hosein, Abolghasem Gorji Hassan, Taheri Mirghaed Masood, Salemi Morteza, Amin Kamyar, Mohammadibakhsh Roghayeh, Bragazzi Nicloa Luigi, Sohrabi Rahim
Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Caspian J Intern Med. 2020;11(2):124-134. doi: 10.22088/cjim.11.2.124.
Cardiovascular disease (CVD) is the first cause of mortality worldwide, with all the healthcare systems facing this very challenging issue. Aspirin continues to be the major gold-standard treatment worldwide in the prevention of thrombotic disease in patients with CVD, even though not all individuals respond to antiplatelet therapy in a similar way, being resistant to aspirin. The aim of this study was to determine the prevalence of laboratory defined aspirin resistance in CVD patients worldwide.
Relevant articles were identified through searching EMBASE, PubMed/ MEDLINE, ISI /Web of Science, Scopus, and the Cochrane Library, from January 2000 to February 2018. The methodological quality of the included studies was critically appraised using the Newcastle-Ottawa scale. The pooled prevalence of laboratory defined aspirin resistance was computed using the Der Simonian-Laird random-effect model.
We included 65 studies, with a total of 10,729 patients. The overall prevalence of laboratory defined aspirin resistance in CVD patients was 24.7% ([95%CI 21.4-28.4]. Women were found to be at increased risk of laboratory defined aspirin resistance compared to men, with an odds ratio of 1.16 [95%CI 0.87-1.54].
Doctors and healthcare providers should pay special attention to aspirin resistance since lack of awareness could cause problems and increase mortality in these patients, if not properly treated with higher aspirin doses.
心血管疾病（CVD）是全球首要死因，所有医疗系统都面临这一极具挑战性的问题。阿司匹林仍是全球预防CVD患者血栓性疾病的主要金标准治疗药物，尽管并非所有个体对抗血小板治疗的反应都相似，存在阿司匹林抵抗。本研究旨在确定全球CVD患者中实验室定义的阿司匹林抵抗的患病率。
通过检索EMBASE、PubMed/MEDLINE、ISI/科学网、Scopus和Cochrane图书馆，确定2000年1月至2018年2月期间的相关文章。使用纽卡斯尔-渥太华量表对纳入研究的方法学质量进行严格评估。采用Der Simonian-Laird随机效应模型计算实验室定义的阿司匹林抵抗的合并患病率。
我们纳入了65项研究，共10729例患者。CVD患者中实验室定义的阿司匹林抵抗的总体患病率为24.7%（[95%CI 21.4-28.4]）。发现女性实验室定义的阿司匹林抵抗风险高于男性，优势比为1.16（[95%CI 0.87-1.54]）。
医生和医疗服务提供者应特别关注阿司匹林抵抗，因为如果对这些患者未用更高剂量的阿司匹林进行适当治疗，缺乏认识可能会导致问题并增加死亡率。
