Aspirin resistance in coronary heart disease: Current understandings and strategies

Han, Yaling

doi:10.1515/jtim-2016-0002

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…Aspirin, a commonly used platelet inhibitor in clinical practice, significantly inhibits platelet function and plays an important role in the treatment of cardiovascular and cerebrovascular diseases worldwide, including CHD (Han, 2016). However, as a nonsteroidal anti-inflammatory drug (NSAID), aspirin can also cause numerous adverse effects, including UGIB (Szabo et al, 2017 (Groza et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Association between TNF‐α polymorphisms and the risk of upper gastrointestinal bleeding induced by aspirin in patients with coronary heart disease

Wang

2018

Annals of Human Genetics

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Objective: To investigate the correlation of tumor necrosis factor α (TNF-α) polymorphisms with upper gastrointestinal bleeding (UGIB) induced by enteric-coated aspirin in coronary heart disease (CHD) patients. Methods:In total, 154 CHD patients taking enteric-coated aspirin were enrolled in this study. Patients were divided into the UGIB group (n = 57) and non-UGIB group (n = 97) based on the presence or absence of signs of UGIB, respectively. TNF-α polymorphism (-857C > T, -863C > A, and -1031T > C) genotyping was performed using polymerase chain reaction (PCR) amplification with sequence-specific primers (PCR-SSP). Results: Patients who had the CC genotype and C allele of -1031T > C exhibited a significantly increase risk of UGIB after receiving enteric-coated aspirin (CC vs. TT: odds (OR) (95% confidence interval (CI)): 7.568 (1.527-37.49), P = 0.005; C vs. T: OR (95% CI): 1.852 (1.036-3.312), P = 0.036). Patients who had CA and CA + AA genotypes and the A allele of -863C > A also exhibited an increased risk of aspirininduced UGIB (CA vs. CC: OR (95% CI): 2.415 (1.143-5.101), P = 0.019: CA + AA vs. CC: OR (95% CI): 2.218 (1.123-4.381), P = 0.021; A vs. C: OR (95% CI): 1.788 (1.039-3.078), P = 0.035). However, the TNF-α -857 C > T polymorphism was unrelated to the induction of UGIB by enteric-coated aspirin in CHD patients (P > 0.05). In addition, the haplotypes of CCC (-1031T > C, -863C > A, and -857C > T) markedly reduced the risk of aspirin-induced UGIB in CHD patients. Conclusion: TNF-α -863A and -1031C increased the risk of UGIB induction by enteric-coated aspirin in CHD patients, whereas TNF-α -857C > T was not correlated with the UGIB risk. K E Y W O R D S aspirin, coronary heart disease, polymorphism, TNF-α, upper gastrointestinal bleeding 124

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Section: Discussionmentioning

confidence: 99%

Association between TNF‐α polymorphisms and the risk of upper gastrointestinal bleeding induced by aspirin in patients with coronary heart disease

Wang

2018

Annals of Human Genetics

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“… 9 , 10 Several mechanisms of HAPR have been put forward, such as the decreased biological availability, drug–drug interactions, inadequate doses or poor compliance, reduced absorption due to advanced age or concurrent proton pump inhibitors (PPIs), non-platelet thromboxane A2 (TXA2) synthesis, accelerated platelet turnover, polymorphism of COX/glycoprotein IIβ/IIIα (GPIIβ/IIIα)/P2Y12 receptors/collagen receptors and others. 7 , 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

Predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease

Zhang

Liu

McCaffrey

et al. 2017

CIA

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ObjectivesPrevious studies have illustrated the link between high on-aspirin platelet reactivity (HAPR) with increasing thrombotic risks. The aim of our study was to investigate relative risk factors of HAPR in elderly patients with coronary artery disease.MethodsElderly, hospitalized coronary artery disease patients on regular aspirin treatment were enrolled from January 2014 to September 2016. Medical records of each patient were collected, including demographic information, cardiovascular risk factors, concomitant drugs and routine biological parameters. Arachidonic acid (AA, 0.5 mg/mL) and adenosine diphosphate (ADP, 5 µmol/L) induced platelet aggregation were measured via light transmission assay (LTA) to evaluate antiplatelet responses, referred as LTA–AA and LTA–ADP.ResultsA total of 275 elderly patients were included, with mean age of 77.2±8.1 years, and males accounted for 81.8%. HAPR was defined as LTA–AA in the upper quartile of the enrolled population. HAPR patients tended to have lower renal function (P=0.052). Higher serum uric acid (SUA) level, as well as lower platelet count, hemoglobin and hematocrit were observed in HAPR patients, with a higher proportion of diuretics use (P<0.05). Multivariate analysis revealed that SUA (OR: 1.004, 95% CI: 1.000–1.007, P=0.048), platelet count (OR: 0.994, 95% CI: 0.989–1.000, P=0.045), hematocrit (OR: 0.921, 95% CI: 0.864–0.981, P=0.011) and concomitant P2Y12 receptor inhibitors use (OR: 1.965, 95% CI: 1.075–3.592, P=0.028) were correlated with HAPR. Spearman’s correlation analysis demonstrated an inverse association of LTA–AA with hematocrit (r=−0.234, P<0.001), hemoglobin (r=−0.209, P<0.001) and estimated glomerular filtration rate (r=−0.132, P=0.031).ConclusionSUA, platelet count, hematocrit and P2Y12 receptor inhibitors use were independently correlated with HAPR. These parameters might provide novel therapeutic targets for optimizing antiplatelet therapy.

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“…Pada jurnal penelitan Han (2016) dikatakan pada pasien dengan penyakit kardiovaskular yang stabil, resisten aspirin telah terbukti terkait dengan tiga kali lipat atau lebih besar dari kejadian kardiovaskular merugikan utama (MACEs), bahkan pada pasien PJK yang patuh terhadap terapi aspirin, resistensi aspirin dapat meningkatkan risiko MACEs sebesar 2,4 kali. Deteksi resistensi aspirin dapat dilakukan dengan Optical aggregometry menggunakan Light Transmission Aggregometry (LTA) untuk mengukur tranmisi cahaya melalui sampel agregat platelet, VerifyNow atau perangkat yang bekerja dengan prinsip pengukuran yang sama seperti aggregometri optik, sekaligus mengukur respons aglutinasi trombosit terhadap fibrinogen dan asam arakidonat, Platelet function analyzer (PFA-100) mengukur agregasi trombosit yang diinduksi oleh aliran darah tinggi dan aktivator trombosit, seperti kolagen/epinefrin, dan Bleeding time dengan mengukur waktu pendarahan untuk memeriksa fungsi trombosit dan sejauh ini melalui pendekatan secara in vivo.…”

Section: Hasil Dan Diskusiunclassified

Resistensi Obat Aspirin Terhadap Pasien Penyakit Jantung Koroner: Sebuah Literature Review

Sholih,

Mulki,

Luthfiannisa

et al. 2023

JPS

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Di Indonesia, penyakit jantung koroner menjadi penyumbang angka kematian terbanyak dengan prevalensi yang berkaitan dengan kardiovaskular. Dengan menggunakan obat dari kombinasi fibrinolitik, antikoagulan, dan antiplatelet mampu mengatasi penyakit jantung koroner akut. Terapi yang paling umum digunakan yaitu golongan antiplatelet berupa obat aspirin sebagai pengobatan untuk pengelolaan penyakit kardiovaskular dan pencegahannya. Akan tetapi, dibeberapa penelitian menyatakan bahwa aspirin merupakan antiplatelet konvensional yang terkadang memiliki potensi sebagai penyebab kegagalan dan tidak efektif untuk terapi penyakit jantung koroner, sehingga dapat dikatakan resistensi aspirin. Metode penulisan artikel review ini dengan menggunakan studi literatur ilmiah. Tahapan yang dilakukan diawali dengan menggumpulkan berbagai referensi jurnal melalui basis data PubMed Identifier (PMID), google schoolar, dan science direct dalam kurun waktu 10 tahun terakhir (2013-2023). Kata kunci dalam pencarian sumber literatur yaitu aspirin resistance, aspirin resistance coronary disease, dan aspirin coronary heart diseases. Berdasarkan hasil tinjauan yang telah ditelaah, menunjukkan bahwa terdapat mekanisme resistensi dan faktor yang mempengaruhi resistensi aspirin terhadap pasien penyakit jantung coroner.

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Aspirin resistance in coronary heart disease: Current understandings and strategies

Cited by 7 publications

References 22 publications

Association between TNF‐α polymorphisms and the risk of upper gastrointestinal bleeding induced by aspirin in patients with coronary heart disease

Association between TNF‐α polymorphisms and the risk of upper gastrointestinal bleeding induced by aspirin in patients with coronary heart disease

Predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease

Resistensi Obat Aspirin Terhadap Pasien Penyakit Jantung Koroner: Sebuah Literature Review

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