ASPIRIN RESISTANCE PRObLEMS IN SECONDARY PREVENTION OF ISChEMIC STROkE
https://doi.org/10.25587/SVFU.2021.22.1.005
Abstract
Acetylsalicylic acid is one of the most widely prescribed antiplatelet drugs in medicine. For the evaluation of the effectiveness of antiplatelet drugs in clinical practice, laboratory testing is used as an aggregometry method. This method makes it possible to estimate the aggregation activity of platelets in persons under treatment with acetylsalicylic acid preparations. High aggregation activity of platelets is thought to be associated with aspirin resistance, a state in which acetylsalicylic acid preparations are unable to prevent excess platelet aggregation and platelet events. This is due to the early increase in neurological deficits and the repeated development of ischemic stroke in patients in the acute period. A large number of factors, including race, sex and the carrying of certain genetic polymorphisms, influence the development of aspirin resistance. According to some sources, low aggreragative activity of platelets means increased sensitivity to the drug, which may lead to complications with aspirin, haemorrhagic events of various localizationsin particular. A study of the aggregate activity of platelets in the population will make it possible to avoid unnecessary aspirin intake as a primary and secondary prevention of cardiovascular diseases.
About the Authors
T. E. Everstova
Institute of Medicine, M.K. Ammosov North-Eastern Federal University; Republic’s Hospital No. 2 - Center for Emergency Medical Aid
Russian Federation
Russian Federation
T. Y. Nikolaeva
Institute of Medicine, M.K. Ammosov North-Eastern Federal University
Russian Federation
Russian Federation
References
1. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 71’ edition.
2. Информационный бюллетень №317. Январь 2015 г, Всемирная организация здравоохранения.
3. Campbell CL, Steinhubl SR. Variability in response to aspirin: do we understand the clinical relevance? J ThrombHaemost. 2005; 3: 665-669.
4. Mason PJ, Jacobs AK, Freedman JE. Aspirin resistance and atherothrombotic disease. J Am CollCardiol. 2005; 46: 986-993.
5. Sanderson S, Emery J, Baglin T, et al. Narrative review: aspirin resistance and its clinical implications. Ann Intern Med. 2005;142: 370-380.
6. Baryshnikova G.A. The role of clopidogrel in the treatment and prevention of cardiovascular diseases. ConsiliumMedicum. Vol. 11, № 10. Pp. 130-137.
7. Вавилова Т.В. Гемостазиология в клинической практике. СПб., 2005.
8. Долгов В.В., Свирин В.П. Лабораторная диагностика нарушений гемостаза. Тверь, 2005; 277 c.
9. Мирзаев К.Б., Андреев Д.А., Сычев Д.А. Оценка агрегации тромбоцитов в клинической практике. Рациональная фармакотерапия в кардиологии. 2015; 11(1): 85-91.
10. Nielsen HL, Kristensen SD, Thygesen SS, et al. Aspirin response evaluated by the VerifyNow Aspirin System and light transmission aggregometry. Thromb. Res. 2008; 123(2): 267-73.
11. Казакова М.С., Луговская С.А., Долгов В.В. Референсные значения показателей общего анализа крови взрослого работающего населения. Клиническая лабораторная диагностика. 2012; 6: 43-49.
12. ГОСТ Р 53022.3-2008. Технологии лабораторные клинические. Требования к качеству клинических лабораторных исследований. Часть 3. Правила оценки информативности лабораторных тестов. 2009.
13. Батурин В.А., Иванова А.В., Муравьев К.А., Царукян А.А., Колодяжная Е. Н. Этнические особенности антиагрегантного действия ацетилсалициловой кислоты у жителей Ставропольского края. Медицинский вестник Северного Кавказа. 2020, 15(1): 68-71. DOI - https://doi.org/10.14300/mnnc. 2020.15015.
14. Zheng ASY, Churilov L, Colley RE, et al. Association of Aspirin Resistance With Increased Stroke Severity and Infarct Size. JAMA Neurol. 2013, 70(2): 208-213. doi:10.1001/jamaneurol. 2013, 601.
15. Боровкова Н.Ю., Буянова М.В., Бакка Т.Е. и др. Патогенетические подходы к лечению аспирин-индуцированных гастроэнтеропатий при длительном приеме ацетилсалициловой кислоты у больных с хронической ишемической болезнью сердца. Терапия. 2020; 3: 56-62. Doi: https://dx.doi.org/10.18565/therapy. 2020.3.56-62.
16. Antithrombotic Trialists (ATT) Collaboration. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet, 2009, 373: 1849-60.
17. Kaur R, Kaur M, Singh J. Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies. CardiovascDiabetol. 2018; 17(1): 121. DOI: 10.1186/s12933- 0180763-3.
18. Hovens MM, Snoep JD, Eikenboom JC, et al. Prevalence of persistent platelet reactivity despite use of aspirin: a systematic review. Am Heart J 2007; 153: 175-81. doi: 10.1016/j.ahj. 2006. 10.040.
19. Sabra, A., Stanford, S.N., Storton, S. et al. Assessment of platelet function in patients with stroke using multiple electrode platelet aggregometry: a prospective observational study. BMCNeurol 16, 254 (2016). https:// doi.org/10.1186/s12883-016-0778-x.
20. Kevin A. Friede, MD; Margaret M. Infeld, MD, MS; Ru San Tan, MD; et ak. Influence of Sex on Platelet Reactivity in Response to Aspirin. J Am Heart Assoc. 2020;9:e014726. DOI: 10.1161/JAHA.119.014726.
21. Fan L., Cao J., Liu L. et al. Frequency, risk factors, prognosis, and genetic polymorphism of the cyclooxygenase-1 gene for aspirin resistance in elderly Chinese patients with cardiovascular disease. Gerontology. 2013; 59: 122-131.
Review
For citations:
Everstova T.E., Nikolaeva T.Y. ASPIRIN RESISTANCE PRObLEMS IN SECONDARY PREVENTION OF ISChEMIC STROkE. Vestnik of North-Eastern Federal University. Medical Sciences. 2021;(1):33-40. (In Russ.) https://doi.org/10.25587/SVFU.2021.22.1.005
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