Study Of The Association Between Reticulated Platelets And Aspirin Resistance

Objective: The percentage of reticulated platelets in whole blood (RP percentage) could represent the platelets turnover, by observing the association between RP percentage and aspirin resistance (AR), we try to illuminate whether the increased platelets turnover could cause AR.Methods: We selected 80 patients who were consistent with our study standard, after they took aspirin (100mg/night)≥7 days, we used Whole blood lumi-aggregometer to determine their optical platelet aggregation, and the platelet aggregation was induced by arachidonic acid (AA) and adenosine diphosphate (ADP). Aspirin resistance was defined as the aggregation≥70% induced by ADP and the aggregation≥20% induced by AA, aspirin semi-resistance (ASR) was defined as meeting one, but not both of the above criteria, if both of the above criteria were not met, the condition was defined as aspirin sensitive (AS). We used flow cytometry to determine their RP percentage. We collected the data of other factors that maybe correlate with AR, these factors included gender, age, whether coronary artery disease patients or not, whether cerebrovascular disease patients or not, whether hypertension patients or not, whether diabetes mellitus patients or not, white blood cell count, red blood cell count, blood platelets count, mean platelet volume, total cholesterol concentration, triglycerides concentration, high-density lipoprotein , low-density lipoprotein concentration. We used logistic regression analysis to analyze whether the RP percentage and other factors correlated with AR, in order to screen the independent risk factor for AR. We used ROC curve to evaluate various risk factors'prediction value for AR. Results: There were 15 AR patients(18. 75%),28 ASR patients(35%),37 AS patients(46. 25%) in the study,both AR and ASR patients were 43(53. 75%)。The RP percentage of AR/ASR patients was significantly higher than AS patients(2. 89±2. 27% VS 1. 24±2. 16%,P<0. 01). Logistic regression analysis revealed that RP percentage was an independent risk factor for AR/ASR(P<0. 01), odds ratio 3. 805, 95% confidence interval 1. 995-7. 258. In all the risk factors, the area under ROC curve of RP percentage was maximum(0. 785),the area under ROC curve of triglycerides concentration was the second(0. 604). Logistic regression analysis also showed triglycerides was independent risk factors for AR/ASR,but its prediction value for AR was less than RP percentage.Conclusion: High RP percentage i.e. increased platelets turnover, maybe one of the mechanisms of AR. The contribution of triglycerides for AR was less than RP percentage. Coronary artery disease patients may need to take aspirin many times one day to get the antiplatelet effect, or it was necessary to change aspirin to controlled release or sustained release dosage form, which maybe helpful to overcome the phenomenon of AR.