Aspirin-resistant thromboxane biosynthesis and the risk of myocardial infarction, stroke, or cardiovascular death in patients at high risk for cardiovascular events
Aspirin-resistant thromboxane biosynthesis and the risk of myocardial infarction, stroke, or cardiovascular death in patients at high risk for cardiovascular events
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DOI：
10.1161/01.cir.0000013777.21160.07
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发表时间：
2002-04-09
期刊：
影响因子：
37.8
通讯作者：
Yusuf, S
中科院分区：
文献类型：
--
作者：
Eikelboom, JW;Hirsh, J;Yusuf, S
背景-我们研究了阿司匹林抵抗，定义为血栓素生成的抑制失败，是否增加了心血管事件的风险在高危population.Methods和结果基线尿样从5529加拿大患者参加心脏预后预防评估（HOPE）研究。采用巢式病例对照设计，我们检测了488例接受阿司匹林治疗的心肌梗死患者的尿11-羟血栓烷B水平，这是体内血栓烷生成的标志物。中风或心血管死亡，在5年的随访和488名性别和年龄匹配的对照组也接受阿司匹林谁没有事件。校正基线差异后，心肌梗死、卒中或心血管死亡的复合结局的比值随着11-β血栓素B-2的每一个四分位数的增加而增加，上四分位数患者的风险是下四分位数患者的1.8倍（OR. 1.8; 95% CI，1.2至2.7; P=0.009）。上四分位数的患者心肌梗死风险高2倍（OR，2.0; 95%CI，1.2 - 3.4; P=0.006），心血管死亡风险高3.5倍（OR，3.5; 95%CI，1.7 - 7.4，P = 0.006）。
Background-We studied whether aspirin resistance, defined as failure of suppression of thromboxane generation, increases the risk of cardiovascular events in a high-risk population.Methods and Results-Baseline urine samples were obtained from 5529 Canadian patients enrolled in the Heart Outcomes Prevention Evaluation (HOPE) Study. Using a nested case-control design, we measured urinary 11-dehydro thromboxane B, levels, a marker of in vivo thromboxane generation, in 488 cases treated with aspirin who had myocardial infarction. stroke. or cardiovascular death during 5 years of follow-up and in 488 sex- and age-matched control subjects also receiving aspirin who did not have an event. After adjustment for baseline differences, the odds for the composite outcome of myocardial infarction, stroke, or cardiovascular death increased with each increasing quartile of 11-dehydro thromboxane B-2 with patients in the upper quartile having a 1.8-times-higher risk than those in the lower quartile (OR. 1.8; 95% CI, 1.2 to 2.7; P=0.009). Those in the upper quartile had a 2-times-higher risk of myocardial infarction (OR, 2.0;, 95% CI, 1.2 to 3.4; P=0.006) and a 3.5-times-higher risk of cardiovascular death (OR, 3.5; 95% CI, 1.7 to 7.4, P