Aspirin resistance in Indian patients with coronary artery disease and cardiovascular events
<b>Background</b> : Aspirin resistance is a major problem and its incidence and clinical significance in Indian patients with documented coronary artery disease are not known. <b>Aim</b> : We sought to study the incidence of aspirin resistance and its clinical significance in...
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2009-01-01
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doaj-aa0540883eb547eb9c9e7c719a0790402020-11-25T01:00:54ZengWolters Kluwer Medknow PublicationsJournal of Postgraduate Medicine0022-38590972-28232009-01-01554252256Aspirin resistance in Indian patients with coronary artery disease and cardiovascular eventsThomson VJohn BGeorge PJoseph GJose J<b>Background</b> : Aspirin resistance is a major problem and its incidence and clinical significance in Indian patients with documented coronary artery disease are not known. <b>Aim</b> : We sought to study the incidence of aspirin resistance and its clinical significance in a cohort of Indian patients with coronary heart disease on therapy with aspirin using urinary 11-Dehydrothromboxane B2 levels as a surrogate marker for antiplatelet efficacy. <b>Setting and Design</b> : Non randomized single center prospective study in cohort of patients with stable cardiovascular disease on chronic aspirin therapy attending the cardiology outpatient clinic of a tertiary care hospital. <b>Materials and Methods</b> : Urinary dehydrothromboxane levels were analyzed in a cohort of 63 patients with stable documented coronary artery disease and in 21 healthy volunteers. The cases were followed up prospectively for a median period of 36 (1-53) months. The clinical endpoint was a composite of acute coronary syndrome, stroke, revascularization and death. <b>Statistical Analysis</b> : Comparison of urinary dehydrothromboxane concentration values between various risk factors was done using Mann Whitney U test, a non parametric alternative of independent t test. All statistical analyses were done using SPSS 11.0 (Chicago, USA) software. <b>Results</b> : The median (range) absolute values of urinary11- dehydrothromboxane B2 levels for the healthy volunteers and cases were 440 (286-2050) pg/ml and 320 (72-2600) pg/ml (P=0.007). The corresponding normalized values were 87.3 (43-143) and 60.8 (16.7-943) ng/mmol of creatinine (P=0.131). Among the various vascular risk factors, patients who were overweight had higher absolute levels of 11- urinary dehydrothomboxane B2 levels (P=0.016). There were significantly more clinical events in patients with absolute urinary 11-dehydrothromboxane B2 levels in the upper two quartiles compared to the lower two quartiles (P=0.04). <b>Conclusion</b> : The incidence of aspirin resistance in the cohort of patients with documented heart disease was 38.1%. Patients with elevated absolute urinary dehydrothomboxane levels (>320 pg/ml) on chronic aspirin therapy constitute a high risk subset for recurrent vascular events.http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2009;volume=55;issue=4;spage=252;epage=256;aulast=ThomsonAspirin resistancemyocardial infarctionplatelet aggregation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Thomson V John B George P Joseph G Jose J |
spellingShingle |
Thomson V John B George P Joseph G Jose J Aspirin resistance in Indian patients with coronary artery disease and cardiovascular events Journal of Postgraduate Medicine Aspirin resistance myocardial infarction platelet aggregation |
author_facet |
Thomson V John B George P Joseph G Jose J |
author_sort |
Thomson V |
title |
Aspirin resistance in Indian patients with coronary artery disease and cardiovascular events |
title_short |
Aspirin resistance in Indian patients with coronary artery disease and cardiovascular events |
title_full |
Aspirin resistance in Indian patients with coronary artery disease and cardiovascular events |
title_fullStr |
Aspirin resistance in Indian patients with coronary artery disease and cardiovascular events |
title_full_unstemmed |
Aspirin resistance in Indian patients with coronary artery disease and cardiovascular events |
title_sort |
aspirin resistance in indian patients with coronary artery disease and cardiovascular events |
publisher |
Wolters Kluwer Medknow Publications |
series |
Journal of Postgraduate Medicine |
issn |
0022-3859 0972-2823 |
publishDate |
2009-01-01 |
description |
<b>Background</b> : Aspirin resistance is a major problem and its incidence and clinical significance in Indian patients with documented coronary artery disease are not known. <b>Aim</b> : We sought to study the incidence of aspirin resistance and its clinical significance in a cohort of Indian patients with coronary heart disease on therapy with aspirin using urinary 11-Dehydrothromboxane B2 levels as a surrogate marker for antiplatelet efficacy. <b>Setting and Design</b> : Non randomized single center prospective study in cohort of patients with stable cardiovascular disease on chronic aspirin therapy attending the cardiology outpatient clinic of a tertiary care hospital. <b>Materials and Methods</b> : Urinary dehydrothromboxane levels were analyzed in a cohort of 63 patients with stable documented coronary artery disease and in 21 healthy volunteers. The cases were followed up prospectively for a median period of 36 (1-53) months. The clinical endpoint was a composite of acute coronary syndrome, stroke, revascularization and death. <b>Statistical Analysis</b> : Comparison of urinary dehydrothromboxane concentration values between various risk factors was done using Mann Whitney U test, a non parametric alternative of independent t test. All statistical analyses were done using SPSS 11.0 (Chicago, USA) software. <b>Results</b> : The median (range) absolute values of urinary11- dehydrothromboxane B2 levels for the healthy volunteers and cases were 440 (286-2050) pg/ml and 320 (72-2600) pg/ml (P=0.007). The corresponding normalized values were 87.3 (43-143) and 60.8 (16.7-943) ng/mmol of creatinine (P=0.131). Among the various vascular risk factors, patients who were overweight had higher absolute levels of 11- urinary dehydrothomboxane B2 levels (P=0.016). There were significantly more clinical events in patients with absolute urinary 11-dehydrothromboxane B2 levels in the upper two quartiles compared to the lower two quartiles (P=0.04). <b>Conclusion</b> : The incidence of aspirin resistance in the cohort of patients with documented heart disease was 38.1%. Patients with elevated absolute urinary dehydrothomboxane levels (>320 pg/ml) on chronic aspirin therapy constitute a high risk subset for recurrent vascular events. |
topic |
Aspirin resistance myocardial infarction platelet aggregation |
url |
http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2009;volume=55;issue=4;spage=252;epage=256;aulast=Thomson |
work_keys_str_mv |
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