Department of Cardiology, Medical University of Lodz, Bieganski Hospital, 1/5 Kniaziewicza, 91-347 Lodz, Poland.
Department of Biopharmacy, Chair of Biopharmacy, Medical University of Lodz, 1/5 Kniaziewicza, 91-347 Lodz, Poland.
Medicina (Kaunas). 2021 Jul 12;57(7):706. doi: 10.3390/medicina57070706.
Resistance to ASA (ASAres) is a multifactorial phenomenon defined as insufficient reduction of platelet reactivity through incomplete inhibition of thromboxane A2 synthesis. The aim is to reassess the prevalence and predictors of ASAres in a contemporary cohort of coronary artery disease (CAD) patients (pts) on stable therapy with ASA, 75 mg o.d. We studied 205 patients with stable CAD treated with daily dose of 75 mg ASA for a minimum of one month. ASAres was defined as ARU (aspirin reaction units) ≥550 using the point-of-care VerifyNow Aspirin test. ASAres was detected in 11.7% of patients. Modest but significant correlations were detected between ARU and concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP) ( = 0.144; = 0.04), body weight, body mass index, red blood cell distribution width, left ventricular mass, and septal end-systolic thickness, with trends for left ventricular mass index and prothrombin time. In multivariate regression analysis, log(NT-proBNP) was identified as the only independent predictor of ARU-partial = 0.15, = 0.03. Median concentrations of NT-proBNP were significantly higher in ASAres patients (median value 311.4 vs. 646.3 pg/mL; = 0.046) and right ventricular diameter was larger, whereas mean corpuscular hemoglobin concentration was lower as compared to patients with adequate response to ASA. ASAres has significant prevalence in this contemporary CAD cohort and NT-proBNP has been identified as the independent correlate of on-treatment ARU, representing a predictor for ASAres, along with right ventricular enlargement and lower hemoglobin concentration in erythrocytes.
ASA 抵抗（ASAres）是一种多因素现象，定义为通过不完全抑制血栓素 A2 合成导致血小板反应性不足降低。目的是在接受稳定剂量的 75mg 阿司匹林（ASA）治疗的稳定型冠心病（CAD）患者的当代队列中重新评估 ASAres 的患病率和预测因素。
我们研究了 205 例接受每日 75mg ASA 治疗至少一个月的稳定型 CAD 患者。ASAres 定义为使用即时护理 VerifyNow 阿司匹林检测的 ARU（阿司匹林反应单位）≥550。
11.7%的患者存在 ASAres。ARU 与 N 末端脑利钠肽前体（NT-proBNP）浓度（ = 0.144； = 0.04）、体重、体重指数、红细胞分布宽度、左心室质量和室间隔收缩末期厚度之间存在适度但显著的相关性，与左心室质量指数和凝血酶原时间呈趋势相关。在多变量回归分析中，log（NT-proBNP）被确定为 ARU 的唯一独立预测因子-部分 = 0.15， = 0.03。ASAres 患者的 NT-proBNP 中位数浓度明显更高（中位数 311.4 与 646.3pg/ml； = 0.046），右心室直径较大，而平均红细胞血红蛋白浓度较低与对 ASA 反应良好的患者相比。
ASAres 在这一当代 CAD 队列中具有显著的患病率，NT-proBNP 已被确定为治疗中 ARU 的独立相关因素，与右心室增大和红细胞中血红蛋白浓度降低一起成为 ASAres 的预测因素。
