Evaluation of dose-related effects of aspirin on platelet function - Results from the aspirin-induced platelet effect (ASPECT) study
Evaluation of dose-related effects of aspirin on platelet function - Results from the aspirin-induced platelet effect (ASPECT) study
复制标题
DOI：
10.1161/circulationaha.106.675587
复制
发表时间：
2007-06-26
期刊：
影响因子：
37.8
通讯作者：
Tantry, Udaya S.
中科院分区：
文献类型：
--
作者：
Gurbel, Paul A.;Bliden, Kevin P.;Tantry, Udaya S.
阿司匹林的抗血小板作用是通过抑制血小板环氧合酶-1来实现的.冠心病患者血小板对阿司匹林抵抗的发生率及阿司匹林剂量对其抑制作用的影响存在争议。我们的主要目的是确定患者血小板对阿司匹林的反应程度，通过常用的方法进行测量，并研究阿司匹林剂量与血小板抑制的关系。方法和结果-我们前瞻性研究了阿司匹林剂量对125例稳定的门诊冠心病患者血小板功能的影响，这些患者在一项双盲、双交叉研究中随机分组（81、162和325 mg/d，各持续4周，持续12周）。在所有剂量的阿司匹林下，花生四烯酸（AA）诱导的透光率聚集、血栓弹力图和VerifyNow显示血小板功能低下。在任何1个剂量下，当AA用作激动剂时，整个组中对阿司匹林的抵抗为0%至6%，而通过其他方法[胶原和ADP诱导的透光性聚集，血小板功能分析仪（PFA-100）]，其为1%至27%。通过胶原蛋白诱导的透光率聚集、ADP诱导的透光率聚集、PFA-100（81 mg vs 162 mg，P
Background - The antiplatelet effect of aspirin is attributed to platelet cyclooxygenase-1 inhibition. Controversy exists on the prevalence of platelet resistance to aspirin in patients with coronary artery disease and effects of aspirin dose on inhibition. Our primary aim was to determine the degree of platelet aspirin responsiveness in patients, as measured by commonly used methods, and to study the relation of aspirin dose to platelet inhibition.Methods and Results - We prospectively studied the effect of aspirin dosing on platelet function in 125 stable outpatients with coronary artery disease randomized in a double-blind, double-crossover investigation (81, 162, and 325 mg/d for 4 weeks each over a 12-week period). At all doses of aspirin, platelet function was low as indicated by arachidonic acid (AA)-induced light transmittance aggregation, thrombelastography, and VerifyNow. At any 1 dose, resistance to aspirin was 0% to 6% in the overall group when AA was used as the agonist, whereas it was 1% to 27% by other methods [collagen and ADP-induced light transmittance aggregation, platelet function analyzer (PFA-100)]. Platelet response to aspirin as measured by collagen-induced light transmittance aggregation, ADP-induced light transmittance aggregation, PFA-100 (81 mg versus 162 mg, P