阿司匹林抵抗对冠状动脉介入术后病人的远期影响

目的了解冠状动脉支架术后冠心病患者阿司匹林抵抗（AR）的状况及其远期影响。方法选择经皮冠状动脉介入术（PCI）后不稳定性心绞痛患者118例，在体外应用ADP诱导的血小板最大聚集率≥70％和0．5％花生四烯酸诱导血小板最大聚集率≥20％者为AR患者，并设立复合终点，随访12个月以上。结果有26例被判断为AR，两组患者除性别以外在年龄、冠心病相关危险因素和药物治疗等方面比较差异无统计学意义（P〉0．05）。平均随访期（18．51±7．65）个月，13例发生了终点事件（11．02％），AR患者中6例（23．08％），非AR患者中7例（7．61％），P=0．05；多因素分析提示AR仍是远期不良事件的独立预测因素（HR2．31；95％CI1．23—5．37；P〈0．05）。结论冠状动脉支架术后的冠心病患者中AR发生率22．03％，AR是发生远期不良事件的重要危险因素。

The impact of aspirin resistance on the long-term outcome in patients with coronary artery disease after PCI

Objective To investigate the prevalence of aspirin resistance （ AR）, the impact of AR on the long-term prognosis in patients with coronary artery disease after PCI. Methods A total of 118 unstable angina pectoris patients underwent successful PCI with DES were follow-up. The primary outcome was the composite of death,myocardial infarction,and so on. AP was defined as a max aggregation of ≥ 70% with 10 microM ADP and ≥20% with 0. 5 mg/ml AA. Result We determined that 26 of patients had AR. AR patients were more likely to be women than were aspirin-sensitive patients. Mean follow-up was 18.51 ±7.65 months. During follow-up,AR was associated with an increased risk of primary outcome compared with patients who were aspirin sensitive （23.08% vs 7.60% ,P = 0.037 ）. Multivariate analysis revealed AR hazard ratio （HR） ,2.31 ;95% confidence intervals （CI） 1.23 to 5.37;P =0.023] to be independent predictor of the primary outcome. Conclusions AR was observed in 22.03% and has been associated with an adverse long-term outcome in patients with coronary artery disease.