PERSISTENT INHIBITION OF PLATELET-FUNCTION DURING LONG-TERM TREATMENT WITH 75 MG ACETYLSALICYLIC-ACID DAILY IN MEN WITH UNSTABLE CORONARY-ARTERY DISEASE
PERSISTENT INHIBITION OF PLATELET-FUNCTION DURING LONG-TERM TREATMENT WITH 75 MG ACETYLSALICYLIC-ACID DAILY IN MEN WITH UNSTABLE CORONARY-ARTERY DISEASE
复制标题
DOI：
10.1093/oxfordjournals.eurheartj.a059912
复制
发表时间：
1991-03-01
影响因子：
39.3
通讯作者：
WALLENTIN, L
中科院分区：
文献类型：
--
作者：
BERGLUND, U;WALLENTIN, L
193名患有不稳定型冠状动脉疾病（CAD）（即不稳定型心绞痛或非Q波心肌梗死）的男性患者在入院后72小时内以双盲方式随机接受乙酰水杨酸（阿萨）75 mg/d（n = 100）或安慰剂（n = 93）治疗。在治疗前和治疗后5天、1个月、12个月、18个月和24个月，以胶原蛋白和ADP的离体聚集评价血小板功能。阿萨使胶原蛋白1 mg 1− 1的聚集率从1个月前的81.3 ±1.7%降低到1个月后的34.0 ±1.7%（P<0.001），而安慰剂组没有观察到变化。阿萨组和安慰剂组1个月后ADP 1 μm聚集率分别为42.1 ±1.1%和51.0 ±2.0%（P<0.001）。阿萨对血小板的抑制作用维持了24个月。所有阿萨患者在治疗期间聚集减少。在第二次聚集试验中，累积剂量为300 mg（4次剂量为75 mg）不足以达到最大抑制作用，因此，阿萨75 mg/d在所有患者中均引起血小板抑制作用，在长期治疗期间没有减弱。如果不稳定型冠状动脉疾病患者开始使用低剂量阿萨，建议负荷剂量超过300 mg。
One-hundred-and-ninety-three men with unstable coronary artery disease (CAD) (i.e. unstable angina or a non-Q wave myocardial infarction) were randomized in a double-blind fashion to acetylsalicyclic acid (ASA) 75 mg daily (n = 100) or placebo (n = 93) within 72 h of admission to the Coronary Care Unit. Platelet function was evaluated as ex vivo aggregation toward collagen and ADP before and after 5 days, 1, 12, 18 and 24 months of treatment. ASA decreased aggregation by collagen 1 mg 1−1from 81.3 ±1.7% before to 34.0 ±1.7% after 1 month (P<0.001), while no change was observed in the placebo group. Aggregation by ADP 1 μm after 1 month was 42.1 ±1.1% and 51.0 ±2.0% in the ASA and placebo groups respectively (P<0.001). The platelet inhibition by ASA was maintained during 24 months. All ASA patients had reduced aggregation during treatment. A cumulative dose of 300 mg (4 doses of 75 mg) was not enough for maximal inhibition at the second aggregation test.Thus, ASA 75 mg daily causes platelet inhibition in all patients without attenuation during long-term treatment. If low dose ASA is started in unstable coronary artery disease a loading dose exceeding 300 mg is suggested.