The frequency of aspirin resistance by a modified thrombelastography method and its relationship with clinical and laboratory parameters in patients with stable coronary artery disease Kararli koroner arter hastaliǧi olanlarda modifiye tromboelastogram yöntemi ile aspirin direnci sikliǧi ve klinik ve laboratuvar bulgularla ilişkisi
Turk Kardiyoloji Dernegi Arsivi, cilt.40, sa.1, ss.33-40, 2012 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 40 Sayı: 1
- Basım Tarihi: 2012
- Doi Numarası: 10.5543/tkda.2012.01645
- Dergi Adı: Turk Kardiyoloji Dernegi Arsivi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.33-40
- Anahtar Kelimeler: Aspirin, blood platelets/drug effects, coronary artery disease, drug resistance, platelet aggregation inhibitors, platelet function tests/methods, thrombelastography
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objectives: Aspirin is the cornerstone of antiplatelet therapy in cardiovascular medicine. However, aspirin resistance has been demonstrated in 0.4% to 83.3% of aspirin-receiving patients. The aim of this study was to investigate the frequency of aspirin resistance using a modified thrombelastography (mTEG) method and related clinical and biochemical parameters in patients with stable coronary artery disease (CAD), who received 100 mg/day aspirin. Study design: The study included 168 patients (115 males, 53 females; mean age 60±8 years) with stable CAD, receiving aspirin at a dose of 100 mg/day. Aspirin responsiveness was determined using mTEG, where aspirin resistance was defined as arachidonic acid-induced whole blood platelet aggregation inhibition (PAI) of less than 50%. Results: Aspirin resistance was detected in 27 patients (16.1%). Platelet aggregation inhibition showed negative correlations with hyperlipidemia, smoking, spironolactone use, systolic blood pressure, pulse pressure, and total cholesterol and fibrinogen levels. In multivariate regression analysis, only fibrinogen level (OR=1.063, p=0.010) and pulse pressure (OR=1.197, p=0.023) were found to be independent indicators of aspirin resistance and PAI. In ROC analysis, cut-off values of 50 mmHg for pulse pressure and 400 mg/dl for fibrinogen level predicted aspirin resistance with 88.9% and 74% sensitivity and 64.4% and 68% specificity, respectively. Conclusion: Our findings suggest that measurements of fibrinogen level and pulse pressure may be used as easy and reliable methods in predicting aspirin resistance. © 2012 Türk Kardiyoloji Derneǧi.