Aspirin resistance and ischemic heart disease on Iranian experience
Masoumeh Sadeghi1, Afsoon Emami, Naghmeh Ziyaei
1Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran.
Insights
Aspirin resistance is highly prevalent in Iranian ischemic patients, affecting over 75%. This resistance is more common in women and those with diabetes or severe coronary artery disease.
Area of Science:
- Cardiology
- Pharmacology
- Epidemiology
Background:
- Coronary artery disease (CAD) and myocardial infarction are leading global causes of mortality.
- Aspirin resistance contributes to therapeutic failure in patients experiencing recurrent atherosclerotic events.
- Prevalence of aspirin resistance varies globally (5-45%), with limited data specific to Iran.
Purpose of the Study:
- To evaluate the prevalence of aspirin resistance in Iranian ischemic patients.
- To identify risk factors associated with aspirin resistance in this population.
- To assess the relationship between aspirin resistance and the severity of coronary artery disease.
Main Methods:
- A cross-sectional prospective study enrolled 170 patients with documented coronary artery stenosis.
- Urine samples were collected to measure Thromboxane B2 levels using ELISA.
- Patient data on risk factors and coronary artery involvement (Gensini score) were collected and analyzed.
Main Results:
- A high prevalence of aspirin resistance was observed in 75.3% of the studied patients.
- A significant association was found between higher Gensini scores (indicating severe CAD) and aspirin resistance (P<0.001).
- Aspirin resistance was more prevalent in women (P=0.003) and patients with diabetes (P=0.023).
Conclusions:
- Aspirin resistance is highly prevalent among Iranian ischemic patients, exceeding rates reported in other communities.
- Severe coronary artery disease is significantly associated with increased aspirin resistance.
- The findings highlight the need for further investigation into aspirin resistance in the Iranian population and potential therapeutic adjustments.
Background:
Coronary artery disease (CAD) and myocardial infarction are the most common causes of mortality and morbidity all over the world. Aspirin resistance is an important part of therapeutic failure in patients who experience several atherosclerotic events despite aspirin therapy. Different studies have reported aspirin resistance between 5% and 45% all over the world. According to different responses to aspirin therapy in countries and lack of adequate studies on aspirin resistance in Iran, this study was designed for evaluation of aspirin resistance in ischemic patients.
Materials And Methods:
Total 170 patients with documented coronary artery stenosis with were enrolled in this cross-sectional prospective study. Two cc urine samples were obtained from all the subjects. Then a questionnaire including questions about major risk factors (hypertension, diabetes, hyperlipidemia, obesity and smoking) was completed for each patient. Thromboxane B2 level in urine was measured two times for each patient by one kit of via ELISA method. Gensini modified was usedfor assessment of severity of coronary arteries involvement. Data were analyzed via SPSS 16. with general linear model (univariate).
Results:
75.3% of studied patients were aspirin resistant. There was significant relationship between angiography score and aspirin resistance (P<0.001).Our results also showed that aspirin resistance is more common in studied women than men (P=0.003).Significant correlation was observed between diabetes and aspirin resistance in studied subjects (P=0.023).
Conclusion:
Our study showed aspirin resistance in a sample of Iranian ischemic patients is so prevalent which is higher than other studies in another communities and also aspirin resistance is more common in patients with severe CAD.
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