Prevalence of and risk factors for aspirin resistance in elderly patients with coronary artery disease

作     者：Xian-Feng Liu Jian Cao Li Fan Lin Liu Jian Li Guo-Liang Hu Yi-Xin Hu Xiao-Li Li 

作者机构：First Geriatric Cardiology Division of South Building Chinese PLA General Hospital 28 Fuxing Road Beijing 100853 China 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2013年第10卷第1期

页      面：21-27页

核心收录：

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

基　　金：supported by the Military Healthcare Fund the Supporting Fund from the Ministry of Science and Technology of China (Li Fan) 

主　　题：Aspirin resistance Coronary artery disease Risk factors 

摘      要：Objective To assess the prevalence of and related risk factors for aspirin resistance in elderly patients with coronary artery disease (CAD). Methods Two hundred and forty-six elderly patients (75.9 ±7.4 years) with CAD who received daily aspirin therapy (≥75 mg) over one month were recruited. The effect of aspirin was assessed using light transmission aggregometry (LTA) and thrombelastography platelet mapping assay (TEG). Aspirin resistance was defined as ≥20% arachidonic acid (AA)-induced aggregation and ≥70% adenosine diphosphate (ADP)-induced aggregation in the LTA assay. An aspirin semi-responder was defined as meeting one (but not both) of the criteria described above. Based on the results of TEG, aspirin resistance was defined as ≥50% aggregation induced by AA. Results As determined by LTA, 23 (9.3%) of the elderly CAD patients were resistant to aspirin therapy; 91 (37.0%) were semi-responders. As determined by TEG, 61 patients (24.8%) were aspirin resistant. Of the 61 patients who were aspirin resistant by TEG, 19 were aspirin resistant according to LTA results. Twenty-four of 91 semi-responders by LTA were aspirin resistant by TEG. Multivariate logistic regression analysis revealed that elevated fasting serum glucose level (Odds ratio: 1.517; 95% CI: 1.176–1.957; P = 0.001) was a significant risk factor for aspirin resistance as determined by TEG. Conclusions A significant number of elderly patients with CAD are resistant to aspirin therapy. Fasting blood glucose level is closely associatedwith aspirin resistance in elderlyCAD patients.