Aspirin Resistance: Clinical Significance and Genetic Polymorphism

作者：Xu, Z-H; Jiao, J-R; Yang, R.; Luo, B-Y; Wang, X-F; Wu, F.^*

来源：Journal of International Medical Research, 2012, 40(1): 282-292.

DOI：10.1177/147323001204000128

• ASPIRIN RESISTANCE
• GENETIC POLYMORPHISM
• ANTIPLATELET AGENT
• PROSTAGLANDIN ENDOPEROXIDE SYNTHASE 1 (PTGS1)
• PTGS2
• PLATELET AGGREGATION TESTS

OBJECTIVE: To determine the prevalence, clinical implications and underlying mechanism of aspirin resistance in Chinese patients. METHODS: Platelet aggregation was determined by light transmission aggregometry (LTA) using four different inducers. Patients were divided into aspirin-resistant (AR), aspirin semiresponder (ASR) and aspirin-sensitive (AS) groups, according to their LTA results. Aspirin resistance was assessed by thromboelastography (TEG, with arachidonic acid [AA] or adenosine diphosphate as inducers), serum/urinary 11-dehydrothromboxane B-2 (11-DH-TXB2) assay, platelet function analyser-100 assay and P-selectin assay. Polymorphisms in the prostaglandin endoperoxide synthase 1 (PTGS1) gene (A842G, C50T, C22T, G128A, C644A and C714A), the PTGS2 gene (G765C) and the integrin beta(3) (ITGB3) gene (C196T) were examined. RESULTS: The study included 360 aspirin-treated patients and 314 healthy controls. AS patients had significantly lower levels of 11-DH-TXB2 than AR and ASR patients, and significantly lower levels of P-selectin than AR patients. TEG-AA was more sensitive, specific and consistent than P-selectin in detecting aspirin resistance. The frequency of the PTGS2 G765C mutation was significantly higher in the AR/ASR groups versus the AS group. CONCLUSIONS: TEG-AA was more sensitive, specific and consistent than the P-selectin assay for detecting aspirin resistance, and the PTGS2 G765C mutation may be related to aspirin resistance.

• 出版日期2012-2
• 单位上海交通大学; 上海市闵行区中心医院