Aspirin resistance in patients with acute coronary syndrome. Part 2
Aim. In patients with acute coronary syndrome (ACS), to investigate the prevalence of aspirin resistance, its clinical features, prognostic effects, and potential correction. Material and methods. The study included 100 ACS patients receiving aspirin. Aspirin resistance was diagnosed if at Day 7 of...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
«SILICEA-POLIGRAF» LLC
2011-04-01
|
| Series: | Кардиоваскулярная терапия и профилактика |
| Subjects: | |
| Online Access: | https://cardiovascular.elpub.ru/jour/article/view/1597 |
| _version_ | 1797882620522004480 |
|---|---|
| author | N. S. Frolova R. M. Shakhnovich E. M. Kaznacheeva O. V. Sirotkina A. B. Dobrovolskyi |
| author_facet | N. S. Frolova R. M. Shakhnovich E. M. Kaznacheeva O. V. Sirotkina A. B. Dobrovolskyi |
| author_sort | N. S. Frolova |
| collection | DOAJ |
| description | Aim. In patients with acute coronary syndrome (ACS), to investigate the prevalence of aspirin resistance, its clinical features, prognostic effects, and potential correction. Material and methods. The study included 100 ACS patients receiving aspirin. Aspirin resistance was diagnosed if at Day 7 of aspirin therapy, the level of platelet aggregation (PLA) with arachidonic acid was ≥20%. In addition, a thromboxane A2 (ТхА2) metabolite – 11-dehydro-thromboxane B2 (11DHTxB2), as well as inflammation markers and genetic polymorphisms (sub-unit IIIa – Leu33Pro and cyclooxygenase-2 (COG) genes) were studied. Results. Aspirin resistance was diagnosed in 11% of ACS patients, receiving aspirin in a standard dose of 100 mg/d. The majority of aspirin-resistant patients had ACS with ST segment elevation (STE-ACS). In all aspirin-resistant ndividuals, the resistance was pharmacokinetic. The level of 11DHTxB2, increased at baseline in ACS patients and especially in those with STE-ACS, was reduced during aspirin therapy. The combination of high PLA and high 11DHTxB2 levels was typically associated with true aspirin resistance. In patients with metabolite levels >438 ng/ mmol creatinine, prognosis was significantly worse than in those with lower levels of this parameter. In aspirinresistant patients, the levels of interleukin-6 (IL-6), IL-10, and C-reactive protein (CRP) at baseline and throughout the study were significantly higher than in aspirin-sensitive subjects. There was no significant association between aspirin resistance and Leu33Pro or А842G polymorphisms, while А842G polymorphism was more common in aspirin-resistant patients. Conclusion. In aspirin-resistant patients, the level of ТхА2 metabolite is increased (true resistance). In ACS individuals with high levels of 11DHTxB2, the prognosis was worse. Aspirin resistance could be linked to inflammation activation. There was no consistent association between aspirin resistance and studied genetic polymorphisms. |
| first_indexed | 2024-04-10T03:38:45Z |
| format | Article |
| id | doaj.art-c661ee5419834b1c83712d5fe60cf491 |
| institution | Directory Open Access Journal |
| issn | 1728-8800 2619-0125 |
| language | Russian |
| last_indexed | 2024-04-10T03:38:45Z |
| publishDate | 2011-04-01 |
| publisher | «SILICEA-POLIGRAF» LLC |
| record_format | Article |
| series | Кардиоваскулярная терапия и профилактика |
| spelling | doaj.art-c661ee5419834b1c83712d5fe60cf4912023-03-13T07:23:19Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252011-04-01102475210.15829/1728-8800-2011-2-47-521314Aspirin resistance in patients with acute coronary syndrome. Part 2N. S. Frolova0R. M. Shakhnovich1E. M. Kaznacheeva2O. V. Sirotkina3A. B. Dobrovolskyi4Институт клинической кардиологии им. А.Л.Мясникова ФГУ РКНПК РосмедтехнологииИнститут клинической кардиологии им. А.Л.Мясникова ФГУ РКНПК РосмедтехнологииИнститут клинической кардиологии им. А.Л.Мясникова ФГУ РКНПК РосмедтехнологииПетербургский институт ядерной физики им. Б.П.Константинова РАНИнститут клинической кардиологии им. А.Л.Мясникова ФГУ РКНПК РосмедтехнологииAim. In patients with acute coronary syndrome (ACS), to investigate the prevalence of aspirin resistance, its clinical features, prognostic effects, and potential correction. Material and methods. The study included 100 ACS patients receiving aspirin. Aspirin resistance was diagnosed if at Day 7 of aspirin therapy, the level of platelet aggregation (PLA) with arachidonic acid was ≥20%. In addition, a thromboxane A2 (ТхА2) metabolite – 11-dehydro-thromboxane B2 (11DHTxB2), as well as inflammation markers and genetic polymorphisms (sub-unit IIIa – Leu33Pro and cyclooxygenase-2 (COG) genes) were studied. Results. Aspirin resistance was diagnosed in 11% of ACS patients, receiving aspirin in a standard dose of 100 mg/d. The majority of aspirin-resistant patients had ACS with ST segment elevation (STE-ACS). In all aspirin-resistant ndividuals, the resistance was pharmacokinetic. The level of 11DHTxB2, increased at baseline in ACS patients and especially in those with STE-ACS, was reduced during aspirin therapy. The combination of high PLA and high 11DHTxB2 levels was typically associated with true aspirin resistance. In patients with metabolite levels >438 ng/ mmol creatinine, prognosis was significantly worse than in those with lower levels of this parameter. In aspirinresistant patients, the levels of interleukin-6 (IL-6), IL-10, and C-reactive protein (CRP) at baseline and throughout the study were significantly higher than in aspirin-sensitive subjects. There was no significant association between aspirin resistance and Leu33Pro or А842G polymorphisms, while А842G polymorphism was more common in aspirin-resistant patients. Conclusion. In aspirin-resistant patients, the level of ТхА2 metabolite is increased (true resistance). In ACS individuals with high levels of 11DHTxB2, the prognosis was worse. Aspirin resistance could be linked to inflammation activation. There was no consistent association between aspirin resistance and studied genetic polymorphisms.https://cardiovascular.elpub.ru/jour/article/view/1597ацетилсалициловая кислотарезистентность к аспиринуострый коронарный синдромагрегация тромбоцитовмаркеры воспалениягенетические полиморфизмы |
| spellingShingle | N. S. Frolova R. M. Shakhnovich E. M. Kaznacheeva O. V. Sirotkina A. B. Dobrovolskyi Aspirin resistance in patients with acute coronary syndrome. Part 2 Кардиоваскулярная терапия и профилактика ацетилсалициловая кислота резистентность к аспирину острый коронарный синдром агрегация тромбоцитов маркеры воспаления генетические полиморфизмы |
| title | Aspirin resistance in patients with acute coronary syndrome. Part 2 |
| title_full | Aspirin resistance in patients with acute coronary syndrome. Part 2 |
| title_fullStr | Aspirin resistance in patients with acute coronary syndrome. Part 2 |
| title_full_unstemmed | Aspirin resistance in patients with acute coronary syndrome. Part 2 |
| title_short | Aspirin resistance in patients with acute coronary syndrome. Part 2 |
| title_sort | aspirin resistance in patients with acute coronary syndrome part 2 |
| topic | ацетилсалициловая кислота резистентность к аспирину острый коронарный синдром агрегация тромбоцитов маркеры воспаления генетические полиморфизмы |
| url | https://cardiovascular.elpub.ru/jour/article/view/1597 |
| work_keys_str_mv | AT nsfrolova aspirinresistanceinpatientswithacutecoronarysyndromepart2 AT rmshakhnovich aspirinresistanceinpatientswithacutecoronarysyndromepart2 AT emkaznacheeva aspirinresistanceinpatientswithacutecoronarysyndromepart2 AT ovsirotkina aspirinresistanceinpatientswithacutecoronarysyndromepart2 AT abdobrovolskyi aspirinresistanceinpatientswithacutecoronarysyndromepart2 |