老年男性心血管病患者阿司匹林抵抗与临床预后的关系

目的探讨老年男性心血管病患者阿司匹林抵抗与临床预后的关系。方法选择304例老年男性心血管病患者,平均年龄(75.03±7.77)岁,口服阿司匹林(≥75mg)>1个月,随访时间中位数为1.8年。结果光比浊检测结果显示,131例(43.1%)为阿司匹林不敏感,其中25例(8.2%)为阿司匹林抵抗,106例(34.9%)为阿司匹林半抵抗;阿司匹林敏感组173例(56.9%)。随访期间阿司匹林不敏感组不良事件发生率高于阿司匹林敏感组(18.3%vs 9.8%,HR=1.864,95%CI:1.046-3.324,P=0.039)。COX模型显示阿司匹林不敏感(HR=3.050,95%CI:1.464-6.354,P=0.003)、糖尿病(HR=2.055,95%CI:1.060-3.981,P=0.033)与临床不良事件有关。结论老年男性心血管病患者阿司匹林不敏感者临床不良事件发生风险趋势增加。

Correlation between aspirin resistance and prognosis in elderly male patients with cardiovascular diseases

Objective To study the correlation between aspirin resistance and prognosis in elderly male patients with cardiovascular diseases（CVD）.Methods Three hundred and four elderly male CVD patients at the age of 75.03±7.77 years were enrolled in this study.The patients were treated over one month with oral aspirin（≥75mg daily） and followed up for a median time of 1.8 years.Results Light transmission aggregometry（LTA） showed that 131 patients（43.1%） were insensitive to aspirin,25（8.2%） were sensitive to aspirin,and 106（34.9%） were semi-sensitive to aspirin.The incidence of adverse events was higher in patients who were insensitive to aspirin than in those were sensitive to aspirin（18.3% vs 9.8%,HR=1.864,95%CI： 1.046-3.324,P=0.039）.Cox proportional hazard regression model demonstrated that aspirin insensitivity（HR=3.050,95% CI： 1.464-6.354,P=0.003） and diabetes mellitus（HR=2.055,95% CI： 1.060-3.981,P=0.033） were correlated with adverse events.Conclusion The risk of adverse events tends to increase in elderly male CVD patients who are insensitive to aspirin.