High Frequency of Aspirin Resistance in Patients with Acute Coronary Syndrome

Hobikoglu, Gultekin; Norgaz, Tugrul; Aksu, Hüseyin; Özer, Orhan; Ertürk, Mehmet; Nurkalem, Zekeriya; Narin, Ahmet

doi:10.1620/tjem.207.59

Cited by 43 publications

(38 citation statements)

References 19 publications

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“…Medicaments that suppress inflammatory response to the damage, as recently described for trimetazidine (Kuralay et al 2006), could be of additional interest, while the use of aspirin known as an ti-in fl ammato r y d r u g th at h as anticoagulating and antioxidant features should be considered with care (Hobikoglu et al 2005). Therefore, novel bioengineered compounds should be tested as well as cocktails of classical antioxidants in order to reduce the reperfusion injury within the myocardium (Hung et al 2001), which may become efficient supportive treatments for myocardial recovery after AMI and successful convalescence of patients.…”

Section: Discussionmentioning

confidence: 99%

Persistent Oxidative Stress after Myocardial Infarction Treated by Percutaneous Coronary Intervention

Nikolić-Heitzler

Rabuzin

Tatzber

et al. 2006

Tohoku J. Exp. Med.

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[247][248][249][250][251][252][253][254][255] Acute myocardial infarction causing cardiac ischemia is responsible for the majority of cardiac related deaths. Medical interventions that ensure rapid reperfusion, such as percutaneous coronary intervention, are aimed to allow myocardial re-oxygenation. However, this generates reactive oxygen species, resembling ischemiareperfusion type of injury based on oxidative stress. In the present study we monitored dynamic changes of total serum peroxides, total antioxidant capacity and soluble intercellular adhesion molecule-1 as well as the titer of antibodies against oxidized low-density lipoproteins in the blood during the convalescence period of 32 patients with acute myocardial infarction treated by percutaneous coronary intervention. Samples were taken at admittance and at two hours, four hours, three days and seven days following percutaneous coronary intervention. Total antioxidant capacity dropped to 82% ( p < 0.05). The titer of antibodies against oxidized low-density lipoproteins transiently decreased within the first three days, and increased afterwards. The values of serum peroxides and soluble intercellular adhesion molecule-1 increased continuously in respect to the initial levels reaching the maximum at the time of release from hospital. These findings indicate a persistent oxidative stress that might be associated with intravascular inflammation in patients during convalescence and release from hospital. myocardial infarction; percutaneous coronary intervention; inflammation; soluble intercellular adhesion molecule-1; lipid peroxidation © 2006 Tohoku University Medical Press While oxidative stress has been shown to be related with the age and living habits (Ozbay and Dulker 2002), it plays an important role in the development of vascular diseases that affect vital organs, in particular brain and heart (Zarkovic 2003;Zarkovic et al. 2004;Madamanchi et al.

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Section: Discussionmentioning

confidence: 99%

Persistent Oxidative Stress after Myocardial Infarction Treated by Percutaneous Coronary Intervention

Nikolić-Heitzler

Rabuzin

Tatzber

et al. 2006

Tohoku J. Exp. Med.

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“…At these doses the anti-inflammatory effect of aspirin is generally considered negligible. However, the greatest benefit of low-dose aspirin use is the inhibition of platelet aggregation, which reduces cardiovascular events by modifying the thrombotic response to plaque rupture (Ridker et al 1997;Hannekens et al 1997;Hobikoglu et al 2005).…”

Section: Discussionmentioning

confidence: 99%

Association of C-Reactive Protein with the Presence and Extent of Angiographically Verified Coronary Artery Disease

Memon

Spasojević‐Kalimanovska

Bogavac-Stanojević

et al. 2006

Tohoku J. Exp. Med.

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Prospective studies have demonstrated that markers of inflammation, such as high-sensitivity C-reactive protein (hsCRP) and fibrinogen, predict future cardiovascular disease risk. However, the association between the hsCRP and fibrinogen levels and the extent of coronary stenosis in patients with coronary artery disease (CAD) remains controversial. The aim of our casecontrol study was to assess the association of inflammatory markers with the occurrence and extent of CAD. Serum hsCRP and plasma fibrinogen levels were measured in 138 patients with angiographically assessed CAD and in 183 healthy subjects matched according to age and gender. According to the number of significantly stenosed ( 50%) vessels, the patients were classified in four groups: those without stenosis (0-vessel disease) and those with 1, 2 or 3-vessel disease. The hsCRP and fibrinogen levels were significantly higher in patients than in controls ( p < 0.001). Although the hsCRP and fibrinogen levels tended to increase with the number of stenotic vessels, the differences were only significant for hsCRP ( p < 0.01). Regression analysis indicated hsCRP as an independent predictor for the presence (OR = 3.573, p < 0.05) and extent of CAD (β = 1.095, p < 0.05). In conclusion, the present study is the first report concerning the frequency distribution of hsCRP in Serbian healthy subjects and CAD patients. We have shown that elevated levels of hsCRP are associated with the presence and extent of CAD.atherosclerosis; inflammation; fibrinogen; hsCRP; coronary artery disease

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“…They found that incidence of aspirin resistance in patients with acute MI (in patients with all MI: 36%, in patients with STEMI: 64%, and in patients with NSTEMI: 28%) were higher than in patients with angina (21%) and chest pain of noncardiac origin (18%) and these results were similar to our results. In another study, Hobikoglu et al 12 showed that aspirin resistance is more prevalent in patients with ACS (40.3%) when compared with stable coronary artery disease patients (27%). Krasopoulos et al 9 showed that patients who were classified as aspirin resistant were at about a 4-fold increased risk of nonfatal and fatal cardiovascular,cerebrovascular, or vascular events while taking aspirin than their aspirin sensitive counterparts.…”

Section: Discussionmentioning

confidence: 96%

“…Similarly, previous studies demonstrated aspirin resistance is more common in patients with ACS and acute MI than in patients with stable coronary artery disease or patients with chest pain of noncardiac origin. 11,12 Recently in a systematic review article, Krasopoulos et al showed that E4 Clin. Cardiol.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Significance of Aspirin Resistance in Patients With Chest Pain

Aydınalp¹,

Atar²,

Gülmez³

et al. 2010

Clinical Cardiology

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BackgroundThere are conflicting data in the literature about the clinical significance of aspirin resistance.HypothesisWe aimed to prospectively evaluate the prevalence of biochemical aspirin resistance in patients on aspirin therapy who were admitted to the emergency clinic with chest pain. We also aimed to evaluate the relation between acute coronary syndromes (ACS) and aspirin resistance.MethodsA total of 338 patients were included in the study. Platelet reactivity was measured with the PFA‐100 system (Dade Behring Inc, Deerfield, IL). Aspirin resistance determined by the PFA‐100 was defined as a normal collagen and/or epinephrine closure time despite aspirin treatment (<165 s).ResultsPatients were divided into 4 groups: stable angina pectoris (SAP), unstable angina/non‐ST‐elevation myocardial infarction (UA/NSTEMI), ST‐elevation myocardial infarction (STEMI), and rule out ACS. Aspirin resistance was found in 81 (24%) patients in all groups. Patients with ACS had significantly more aspirin resistance than patients with rule out ACS or patients with SAP (P < .001). In the SAP group, 31 (19.6%) patients; in the UA/NSTEMI group, 19 (35.8%) patients; in the STEMI group, 14 (50%) patients; and in the rule out ACS group, 17 (17.2%) patients had aspirin resistance (P < .001). In the multivariate analysis, cardiac biomarker elevation on admission to emergency department and platelet count appeared as independent factors predictive of aspirin resistance.ConclusionsWe demonstrated that incidence of aspirin resistance was significantly higher in patients who were finally diagnosed as ACS, especially in aspirin‐taking patients admitted to the emergency clinic with STEMI. Copyright © 2010 Wiley Periodicals, Inc.

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High Frequency of Aspirin Resistance in Patients with Acute Coronary Syndrome

Cited by 43 publications

References 19 publications

Persistent Oxidative Stress after Myocardial Infarction Treated by Percutaneous Coronary Intervention

Persistent Oxidative Stress after Myocardial Infarction Treated by Percutaneous Coronary Intervention

Association of C-Reactive Protein with the Presence and Extent of Angiographically Verified Coronary Artery Disease

The Clinical Significance of Aspirin Resistance in Patients With Chest Pain

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