Rational Pharmacotherapy in Cardiology

Advanced search


Full Text:


Aim. To estimate the prevalence of atherothrombotic complications depending on platelet sensitivity to acetylsalicylic acids (ASA) in patients with stable angina.

Material and methods. 96 patients with stable angina of II-III functional classes received basic therapy included ASA (125 mg daily) to prevent atherothrombotic complications. Platelet ability to aggregation was assessed with laser aggregometer. Resistance to ASA was determined, if cumulative index of platelet aggregation (after stimulation with ADF, 5 µmol\l) remain on the level of 50-70% in spite of ASA. Atherothrombotic complications (cardiovascular death, myocardial infarction, unstable angina, cerebral stroke) were registered during 24-36 months.

Results. Resistance to ASA was detected in 24% of patients. Atherothrombotic complications were registered in 66% of patients with ASA resistance (myocardial infarction or unstable angina were observed in 14 patients of 21 ones) and in 27% of patients with sensitivity to ASA (myocardial infarction or unstable angina were observed in 19 of 70 ones). Besides, resistance to ASA was associated with high rate of thrombosis of installed stents or coronary artery bypasses.

Conclusion. In patients with unstable angina insufficient inhibition of platelet aggregation with ASA is associated with 2, 45 times increase in risk of atherothrombotic complications and higher rate of thrombosis of installed stents or coronary artery bypasses.

About the Authors

N. F. Putchinyan
Saratov research institute of cardiology of Roszdrav
Russian Federation

N. V. Furman
Saratov research institute of cardiology of Roszdrav
Russian Federation

P. Ya. Dovgalevskyi
Saratov research institute of cardiology of Roszdrav
Russian Federation


1. Диагностика и лечение стабильной стенокардии. Российские рекомендации. Кардиоваск тер профилакт 2004;(прил.):2-27.

2. Панченко Е.П., Добровольский А.Б. Тромбозы в кардиологии. Механизмы развития и возможности терапии. М.: Спорт и культура, 1999.

3. Antithrombotic Trialists' Collaboration. Collaborative metaanalysis of ran￾domised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324:71-86.

4. Gum PA, Kottke-Marchant K, Poggio ED, et al. Profile and prevalence of aspirin resistance in patients with cardiovascular disease. Am J Cardiol 2001;88:230-5.

5. Gum PA, Kottke-Marchant K, Welsh PA, et al. A prospective, blinded determination of the natural history of aspirin resistance among stable patients with cardiovascular disease. J Am Coll Cardiol 2003;41:961-5.

6. Eikelboom JW, Hirsh J, Weitz JI, et al. Aspirinresistant thromboxane biosynthesis and the risk of myocardial infarction, stroke, or cardiovascular death in patients at high risk for cardiovascular events. Circulation 2002;105:1650-5.

7. Michelson AD, Cattaneo M, Eikelboom JW, et al., on behalf of the Platelet Physiology Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Apirin Resistance: position paper of the Working Group on Aspirin Resistance. J Thromb Haemost 2005;3:1309-11.

8. Chen W-H, Lee P-Y, Ng W, et al. Aspirin resistance is associated with a high incidence of myonecrosis after non-urgent percutaneous coronary intervention despite clopidogrel pretreatment. J Am Coll Cardiol 2004;43:1122-6.

9. Patrono C, Coller B, FitzGerald GA, et al. Platelet-active drugs: the relationships among dose, effectiveness, and side effects. Chest 2004;126:234S-264S.

10. Cotter G, Shemesh E, et al. Lack of aspirin effect: aspirin resistance or resistance to taking aspirin? Am Heart J 2004;147:293-300.

11. Catella-Lawson F, Reilly MP, Kapoor SC, et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med 2001;345:1809- 17.

12. Kurth T, Glynn RJ, Walker AM, et al. Inhibition of clinical benefits of aspirin on first myocardial infarction by nonsteroidal anti-inflammatory drugs. Circulation 2003;108:1191-5.

13. Kawasaki T, Ozeki Y, Igawa T, et al. Increased platelet sensitivity to collagen in individuals resistant to low-dose aspirin. Stroke 2000;31:591- 5.

14. Erlinge D, Borna C, Lazarowski E, et al. Resistance to aspirin is increased by ST-elevation myocardial infarction and correlates with adenosine diphosphate levels. Thromb J 2005;3:10.

15. Syrbe G, Redlich H, Weidlich B, et al. Individual dosing of ASA prophylaxis by controlling platelet aggregation. Clin Appl Thromb Hemost 2001;7:209-13.

16. Valles J, Santos MT, Aznar J, et al. Erythrocyte promotion of platelet reactivity decreases the effectiveness of aspirin as an antithrombotic therapeutic modality: the effect of low-dose aspirin is less than optimal in patients with vascular disease due to prothrombotic effects of erythrocytes on platelet reactivity. Circulation 1998;97:350-5.

17. Freedman JE. CD40-CD40L and platelet function: beyond hemostasis. Circ Res 2003;92:944-6.

18. Guidelines on platelet function testing. The British Society for Haematology BCSH Haemostasis and Thrombosis Task Force. J Clin Pathol 1988;41:1322-1330.

19. Волков В.И., Рябуха В.В., Запровальная О.Е., Ладный А.И. Диагностика резистентности к аспирину у больных с ишемической болезнью сердца. Украiнський кардiологiчний журнал 2006;(3):

20. Баркаган З.С., Момот А.П. Основы диагностики нарушений гемостаза. М.: Ньюдиамед, 1999.

For citation:

Putchinyan N.F., Furman N.V., Dovgalevskyi P.Y. RESISTANCE TO ACETYLSALICYLIC ACID AND PREVALENCE OF THROMBOSIS IN PATIENTS WITH STABLE ANGINA. Rational Pharmacotherapy in Cardiology. 2007;3(4):11-14. (In Russ.)

Views: 2065

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)