Resistance to low-dose aspirin therapy among patients with acute coronary syndrome in relation to associated risk factors

Salama, M M; A., Morad; Saleh, Meylan; Sabri, Nagwa A.; Zaki, Mona M.; ElSafady, L A

doi:10.1111/j.1365-2710.2009.01083.x

Cited by 16 publications

(11 citation statements)

References 39 publications

(41 reference statements)

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“…ELISA was used to detect serum levels of estrogen, hs-CRP and MMP-9 (8–10). Coronary angiography was performed in all patients, including healthy subjects, according to the Judkins technique (11). Two experienced interventional cardiologists assessed the extent of coronary artery lesions and the number of stenosed coronary vessels.…”

Section: Methodsmentioning

confidence: 99%

Correlation between the severity of coronary artery lesions and levels of estrogen, hs-CRP and MMP-9

Guo

Zhang

Jun-biao

et al. 2014

Experimental and Therapeutic Medicine

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The aim of this study was to investigate the correlation between the severity of coronary artery lesions in patients with acute coronary syndromes (ACS) and levels of estrogen, high-sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinase-9 (MMP-9). A total of 65 patients with ACS, 33 patients with stable angina pectoris (SAP) and 36 healthy controls were randomly enrolled. Patients with ACS were subdivided into two groups: Acute myocardial infarction (AMI; n=30) and unstable angina pectoris (UAP; n=35). Serum levels of estrogen, hs-CRP and MMP-9 were detected in the four groups of subjects. Serum estrogen levels in patients with AMI, UAP and SAP were significantly lower than those in the control group (P<0.05). Estrogen levels were also significantly different among the AMI, UAP and SAP groups (P<0.05), with a progressive increase across the three respective groups. Compared with healthy subjects, patients with AMI had the highest levels of hs-CRP and MMP-9, followed in descending order by those with UAP and SAP (P<0.05). Levels of hs-CRP and MMP-9 were also significantly different among the AMI, UAP and SAP groups (P<0.05). Serum estrogen levels were negatively correlated with hs-CRP and MMP-9 levels (r=−0.6634 and −0.6878, respectively; both P<0.05). hs-CRP and MMP-9 levels correlated positively (r=0.7208, P<0.05). The number of stenosed coronary vessels was negatively correlated with estrogen levels (r=−0.6467, P<0.05), and positively correlated with hs-CRP and MMP-9 levels (r=0.6519 and 0.6835, respectively; both P<0.05). In conclusion, serum estrogen, hs-CRP and MMP-9 levels were significantly correlated with the severity of coronary artery lesions. There was also a significant correlation between serum estrogen, hs-CRP and MMP-9 levels. These data indicate that serum estrogen, hs-CRP and MMP-9 have the potential to be used as biomarkers for evaluating the severity of coronary artery lesions and the stability of coronary artery plaques.

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Section: Methodsmentioning

confidence: 99%

Correlation between the severity of coronary artery lesions and levels of estrogen, hs-CRP and MMP-9

Guo

Zhang

Jun-biao

et al. 2014

Experimental and Therapeutic Medicine

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“…reduced TXA 2 production and platelet sensitivity) to antiplatelet therapies. [31,[59][60][61][62][63][64][65][66] The inability to substantially reduce the risk of CV events and the lack of laboratory responsiveness to aspirin in patients with diabetes may be related to a mismatch between the mechanism of action and pharmacology of aspirin and the platelet abnormalities observed in patients with diabetes.…”

Section: Aspirin: Antiplatelet Effects and Pharmacokineticsmentioning

confidence: 99%

Aspirin in the prevention of cardiovascular events in patients with diabetes

Bell

2016

Postgraduate Medicine

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Diabetes imparts a substantial increased risk for cardiovascular disease-related mortality and morbidity. Because of this, current medical guidelines recommend prophylactic treatment with once-daily, low-dose aspirin (acetylsalicylic acid) for primary and secondary prevention of cardiovascular (CV) events in high-risk patients. However, only modest reductions in CV events and mortality have been observed with once-daily aspirin treatment in patients with diabetes, including patients with a previous CV event, perhaps because of disparity between aspirin pharmacokinetics and diabetes-related platelet abnormalities. Once-daily aspirin irreversibly inactivates platelets for only a short duration (acetylsalicylic acid half-life, approximately 15-20 minutes), after which time newly generated, active platelets enter the circulation and weaken aspirin's effect. Platelets from patients with diabetes are more reactive and are turned over more rapidly than platelets from normal individuals; the short inhibitory window provided by once-daily aspirin may therefore be insufficient to provide 24-h protection against CV events. Alternative conventional aspirin regimens (e.g. higher daily dose, twice-daily dosing, combination with clopidogrel) and newer formulations (e.g. 24-h, extended-release) have been proposed to overcome the apparent limited efficacy of conventional aspirin in patients with diabetes; however, tolerability concerns and limited clinical efficacy data need to be taken into account when considering the use of such regimens. ARTICLE HISTORY

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“…However, total abs nence from alcohol is apparently another 'healthy living' concept calling for a careful evalua on. Aspirin daily in low doses has been shown to have a protec ve effect against vascular incidents -specifically, it decreases the risk of ischemic stroke in women and myocardial infarc on in men [1357,1361]. This is valid, however, only when aspirin is used as an adjunct in management of other cardiovascular risk factors, and not as an alterna ve.…”

Section: S Snegov the Experiments Of Professor Bran Ng (1977)mentioning

confidence: 99%

“…This is valid, however, only when aspirin is used as an adjunct in management of other cardiovascular risk factors, and not as an alterna ve. 5-25% of the popula on, however, is resistant to the an aggregant effects of aspirin in low doses, and high doses may be associated with other type of complica ons [1360,1361]. Therefore, taking aspirin is not a universal op on for all ageing people.…”

Section: S Snegov the Experiments Of Professor Bran Ng (1977)mentioning

confidence: 99%

DNA repair systems

Chakarov¹,

Petkova²,

Russev³

2014

Biodiscovery

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This paper provides detailed insight into the mechanisms of repair of different types of DNA damage and the direct molecular players (enzymes repairing the damage or tagging the damaged site for further processing; damage sensor molecules; other signalling and effector molecules). The gene c bases of diseases and condi ons associated with defec ve DNA repair are comprehensively reviewed, from the 'classic' severe diseases such as xeroderma pigmentosum and Cockayne syndrome to the much more subtle UV sensi vity syndromes. The review analyses the basic molecular mechanisms underlying the rela vely rare monogenic diseases of DNA repair and management of genome integrity as well as the common mul factorial diseases and condi ons with late onset that are associated with increased levels of oxida ve stress (metabolic syndrome, diabetes type 2, cardiovascular disease) and with accumula on of 'errors' in DNA (normal and pathological ageing phenotypes, various cancers). The role of cell cycle checkpoints in dividing cells and the mechanisms of decision-making for the fate of a damaged cell are discussed with regards to the cell homeostasis in normal and cancerous ssues. The role of major DNA damageassociated signalling and effector molecules (p53, ATM, poly-(ADP-ribose)-polymerase, DNA-dependent protein kinase, BRCA proteins, re noblastoma protein, and others) is discussed and illustrated with examples in the context of health and disease. DNA repair and programmed cell death are viewed together as a unified mechanism for limi ng the presence of damaged cells and cells with poten ally oncogenic transforma on in mul cellular organisms. Special a en on is paid to ageing as a natural phenomenon and an adap ve evolu onary mechanism, with a brief outline of 'successful ageing'. The differen al rates of repair of DNA in transcribed and nontranscribed regions of the genome and the specifici es of DNA repair profile in some types of cells (terminally differen ated cells, pluripotent stem cells, etc.) and in certain taxonomic groups (e.g. 'the rodent repairadox') are discussed with regards to replica ve ageing and the evolu onary processes on microand macroscale. The role of mutagenesis as a 'hit and miss' mechanism and the 'leakiness' of DNA repair for increasing gene c diversity in the course of individual life and on evolu onary scale and the phenomenology of ongoing molecular evolu on are extensively reviewed. Conflict of Interests:No poten al conflict of interest was disclosed by any of the authors. Types of DNA repair systemsIf you wish for peace, prepare for war.Publius Flavius Vege us Renatus, De Re Militari (circa 380 AD).DNA damage is a very broad term, encompassing many different types of lesions in DNA.Accordingly, DNA repair comprises many different types of pathways and mechanisms covering virtually every possible type of injury to the sequence or the structure of DNA.Accep ng Lewin's defini on of DNA damage "... any change that introduces a devia on from the usual double-helical structure" [1] , we may pre...

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Resistance to low-dose aspirin therapy among patients with acute coronary syndrome in relation to associated risk factors

Cited by 16 publications

References 39 publications

Correlation between the severity of coronary artery lesions and levels of estrogen, hs-CRP and MMP-9

Correlation between the severity of coronary artery lesions and levels of estrogen, hs-CRP and MMP-9

Aspirin in the prevention of cardiovascular events in patients with diabetes

DNA repair systems

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