Biomedical Science Letters (대한의생명과학회지)

The Korean Society for Biomedical Laboratory Sciences (대한의생명과학회)
권호 표지

Prevalence of Aspirin Resistance and Clinical Characteristics in Patients with Cerebral Infarction

  • Choi, Jong-Tae (Department of Biomedical Laboratory Science, Konyang University) ;
  • Shin, Kyung-A (Department of Clinical Laboratory Science, Shinsung University) ;
  • Kim, Young-Kwon (Department of Biomedical Laboratory Science, Konyang University)
  • Received : 2013.07.30
  • Accepted : 2013.09.14
  • Published : 2013.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Aspirin is still the mainstay of antiplatelet therapy in the cardiovascular and cerebrovascular disease. However, some patients are not responsive to the antithrombotic action of aspirin. The aim of this study was to assess the prevalence and clinical characteristics of aspirin resistance in patients with cerebral infarction. We tested platelet function in 557 patients who had been treated with aspirin in J general hospital. Platelet function was tested using the multiple electrode platelet aggregometry (MEA). Platelet reactivity was expressed as area under the aggregation curve (AUC, U) and >30 AUC was defined as aspirin resistance. Aspirin resistance was detected in 16.2% patients. There was not any significant differences in age, gender between aspirin resistance and aspirin sensitive patients. WBC was significantly higher in patients with aspirin resistance (P < .05). HDL-cholesterol was significantly higher in patients with aspirin sensitive (P < .05). Aspirin resistance was positive correlation with platelet count (r =.314, P =.003). The prevalence of aspirin resistance in cerebral infarction was 16.2%, and platelet count were related with aspirin resistance.

Keywords

References

  1. Abaci A, Yilmaz Y, Caliskan M, Bayram F, Cetin M, Unal A, Cetin S. Effect of increasing doses of aspirin on platelet function as measured by PFA-100 in patients with diabetes. Thromb Res. 2005. 116: 465-470. https://doi.org/10.1016/j.thromres.2005.02.005
  2. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002. 324: 71-86. https://doi.org/10.1136/bmj.324.7329.71
  3. Chen WH, Cheng X, Lee PY, Ng W, Kwok JY, Tse HF, Lau CP. Aspirin resistance and adverse clinical events in patients with coronary artery disease. Am J Med. 2007. 120: 631-635. https://doi.org/10.1016/j.amjmed.2006.10.021
  4. Comerota AJ. Effect on platelet function of cilostazol, clopidogrel, and aspirin, each alone or in combination. Atheroscler Suppl. 2005. 6: 13-19.
  5. Eikelboom JW, Hankey GJ, Thom J, Bhatt DL, Steg PG, Montalescot G, Johnston SC, Steinhubl SR, Mak KH, Easton JD, Hamm C, Hu T, Fox KA, Topol EJ; Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Investigators. Incomplete inhibition of thromboxane biosynthesis by acetylsalicylic acid: determinants and effect on cardiovascular risk. Circulation 2008. 118: 1705-1712. https://doi.org/10.1161/CIRCULATIONAHA.108.768283
  6. Eikelboom JW, Hirsh J, Weitz JI, Johnston M, Yi Q, Yusuf S. Aspirin-resistant thromboxane biosynthesis and the risk of myocardial infarction, stroke, or cardiovascular death in patients at high risk for cardiovascular events. Circulation 2002. 105: 1650-1655. https://doi.org/10.1161/01.CIR.0000013777.21160.07
  7. Fateh-Moghadam S, Plockinger U, Cabeza N, Htun P, Reuter T, Ersel S, Gawaz M, Dietz R, Bocksch W. Prevalence of aspirin resistance in patients with type 2 diabetes. Acta Diabetol. 2005. 42: 99-103. https://doi.org/10.1007/s00592-005-0186-y
  8. Gersh BJ, Opie LH. Antithrombotic agents: platelet inhibitors, anticoagulants and fibrinolytics. In: Drugs for the heart. 3rd ed. 1991. pp. 217-246. WB Saunders Co. Philadelphia, USA.
  9. Grotemeyer KH, Scharafinski HW, Husstedt IW. Two-year follow-up of aspirin responder and aspirin non responder. A pilot-study including 180 post-stroke patients. Thromb Res. 1993. 71: 397-403. https://doi.org/10.1016/0049-3848(93)90164-J
  10. Grove EL, Hvas AM, Kristensen SD. Aspirin resistance: myth or major problem?. Scand J Clin Lab Invest. 2008. 68: 257-259. https://doi.org/10.1080/00365510701805423
  11. Gum PA, Kottke-Marchant K, Poggio ED, Gurm H, Welsh PA, Brooks L, Sapp SK, Topol EJ. Profile and prevalence of aspirin resistance in patients with cardiovascular disease. Am J Cardiol. 2001. 88: 230-235. https://doi.org/10.1016/S0002-9149(01)01631-9
  12. Gum PA, Kottke-Marchant K, Welsh PA, White J, Topol EJ. A prospective, blinded determination of the natural history of aspirin resistance among stable patients with cardiovascular disease. J Am Coll Cardiol. 2003. 41: 961-965. https://doi.org/10.1016/S0735-1097(02)03014-0
  13. Hankey GJ, Eikelboom JW. Aspirin resistance. Lancet. 2006. 367: 606-617. https://doi.org/10.1016/S0140-6736(06)68040-9
  14. Hovens MM, Snoep JD, Eikenboom JC, van der Bom JG, Mertens BJ, Huisman MV. Prevalence of persistent platelet reactivity despite use of aspirin: a systematic review. Am Heart J. 2007. 153: 175-181. https://doi.org/10.1016/j.ahj.2006.10.040
  15. Jambor C, Weber CF, Gerhardt K, Dietrich W, Spannagl M, Heindl B, Zwissler B. Whole blood multiple electrode aggregometry is a reliable point-of-care test of aspirin-induced platelet dysfunction. Anesth Analg. 2009. 109: 25-31. https://doi.org/10.1213/ane.0b013e3181a27d10
  16. Kang MY, Cho YM, Kim HK, An JH, Ahn HY, Yoon JW, Choi HS, Lee JS, Park KS, Kim SY, Lee HK. Prevalence and Clinical Characteristics of Aspirin Resistance in the Patients with Type 2 Diabetes Mellitus. Korean Diabetes J. 2008. 32: 53-59. https://doi.org/10.4093/kdj.2008.32.1.53
  17. Kim JH, Kim YS, Sohn SI, Cho KH. Biochemical Aspirin Resistance Affect on Stroke Severity in Acute Stroke Patients Who Had Taken Aspirin. J Korean Neurol Assoc. 2011. 29: 303-308.
  18. Lee YK, Kim HS, Park JY, Kang HJ. Incidence of Aspirin Resistance in the Patient Group of a University Hospital in Korea. Korean J Lab Med. 2008. 28: 251-257. https://doi.org/10.3343/kjlm.2008.28.4.251
  19. Lim YH, Park BH, Cho CG. Prevalence of aspirin resistance and related factors in patients with type-2 diabetes mellitus. Korean J Med. 2009. 76: 321-328.
  20. Liu XF, Cao J, Fan L, Liu L, Li J, Hu GL, Hu YX, Li XL. Prevalence of and risk factors for aspirin resistance in elderly patients with coronary artery disease. J Geriatr Cardiol. 2013. 10: 21-27.
  21. McKee SA, Sane DC, Deliargyris EN. Aspirin resistance in cardiovascular disease: a review of prevalence, mechanisms, and clinical significance. Thromb Haemost. 2002. 88: 711-715.
  22. Mehta J, Mehta P, Burger C, Pepine CJ. Platelet aggregation studies in coronary artery disease. Past 4. Effect of aspirin. Atherosclerosis 1978. 31: 169-175.
  23. Mehta SS, Silver RJ, Aaronson A, Abrahamson M, Goldfine AB. Comparison of aspirin resistance in type 1 versus type 2 diabetes mellitus. Am J Cardiol. 2006. 97: 567-570. https://doi.org/10.1016/j.amjcard.2005.09.093
  24. Mueller MR, Salat A, Stangl P, Murabito M, Pulaki S, Boehm D, Koppensteiner R, Ergun E, Mittlboeck M, Schreiner W, Losert U, Wolner E. Variable platelet response to low-dose ASA and the risk of limb deterioration in patients submitted to peripheral arterial angioplasty. Thromb Haemost. 1997. 78: 1003-1007.
  25. Oh DJ. Aspirin resistance in patients undergoing dialysis. The Korean Journal of Nephrology 2011. 30: 131-133.
  26. Pamukcu B, Oflaz H, Onur I, Oncul A, Umman B, Koylan N, Bugra Z, Meric M, Nisanci Y. Aspirin-resistant platelet aggregation in a cohort of patients with coronary heart disease. Blood Coagul Fibrinolysis. 2007. 18: 461-465. https://doi.org/10.1097/MBC.0b013e32814db7e7
  27. Yim JH, Park SW, Lee SW, Choi HO, Lee PH, Sun BJ, Park DW, Kim YH, Lee CW, Hong MK, Kim JJ, Park SJ. Clinical impact of aspirin resistance measured using the Ultegra Rapid Platelet Function Assay-ASA in patients undergoing percutaneous coronary intervention. Korean J Med. 2009. 76: 685-691.