Correlated Study Of Aspirin Resistance And P-selection In Patients With Coronary Heart Disease

It is proved that aspirin can effectually prenvent the happening of myocardial infarction, cerebral apoplexy and other death of circulating system in many clinical trails. It is now used for the first-level and second-level prevention for thromboembolic disease. However, some patients still suffer from thromboembolic disease after regularly taking of aspirin because the existence of aspirin resistance. Our objective is to find out the prevalence and risk factors of aspirin resistance, and to investigate the correlationship between aspirin resistance and P-selection in platelet.Methods 50 patients with coronary disease(male 26, female 24) intook aspirin 100mg/d for two weeks. Platelet aggregation (PAG) induced with adenosine diphosphate (ADP) were detected. According to PAG, CHD patients was divided into two subgroups: aspirin-resistant subgroup and aspirin-sensitive subgroup. P-selection expression was detected before and after treatment.Results 9 patients(18%) showed AR.The prevalence was similar in male and famale(P=0.385). The blood LDL-C level(3.65±1.17 vs 2.93±1.03mmol/L, P=0.018), hypertension(66.7% vs 29.2%, P=0.03), total cholesterol level (5.43±1.6 vs 5.09±1.63mmol/L, P=0.042)and hemoglobin level(130±7.9 vs 139±14.75g/L, P=0.05)was higher in AR, compared with Aspirin sensitive patients. Logistic regression revealed that blood LDL-C level (or=3.26) and hypertension (or=3.89) were the independent factors of AR (P<0.05). The expression of P-selection was significantly higher in AR patients than in AS (2.97±1.64 vs 2.48±1.01, P=0.003). P-selection has no significant change in AR or AS groups before aspirin interference while they showed difference after interference respectively(2.97±1.64vs2.48±1.01, P=0.003). Group comparison revealed that P-selection level had no much difference before and after interference in AR subgroup(3.36±1.55 vs 2.97±1.64, P=0.08), compared with its significant deviation in AS subgroup(3.34±1.10 vs 2.48±1.01, P=0.03). Positive correlation was shown between PS and PAG in AR subgroup.Conclusion The incidence rate of AR is 18% and there is no significant difference between male and female. The blood LDL-C level and hypertension are the independent factors of AR. The trail also reveals that AR has no relationship with the age, weight, blood glouse, platelet, leukocyte and hemoglobin. P-selection expression can be used as an effective standard of measuring AR. Aspirin reduces the activation and aggregation of platelets and inhibit the expression of P-selection indirectly by irreversibly acetylating cyclooxygenase-1 (COX-1),and thereby reduces TXA2 produced by platelets. Positive correlation exists between PS expression and AR.