| Purpose:To investigate the effects of long-term use of low-dose aspirin on uric acid metabolism in patients with primary and secondary prevention of coronary artery disease,and to evaluate the effect of this change on renal function in such patients.Materials and method:1.A total of 926 patients with atherosclerosis were enrolled in the primary prevention group,541 of which took aspirin to prevent severe cardiovascular events,and were set as the aspirin prevention group.Another 385 patients were not taking medication and were set the observation waiting group.The patient's 12-month outpatient follow-up data were collected,including the patients' general clinical characteristics and biochemical parameters,and the changes of uric acid and renal function were compared between the groups.2.A total of 640 patients with coronary stent implantation were enrolled in the secondary prevention group.According to the difference of monoclonal antiplatelet drug after one year of dual antiplatelet therapy(DAPT)with aspirin + clopidogrel,the patients were divided into aspirin group(564)and clopidogrel group(76).According to the difference of uric acid value at the end of follow-up at the 24 th month after surgery,patients in the aspirin group after stenting were subdivided into high uric acid group and normal uric acid group.The outpatient follow-up data of the patients 24 months after surgery were collected,including the general clinical characteristics and biochemical indicators of the patients,and the changes of uric acid and renal function indexes were compared between the groups.Results:1.In the aspirin prevention group,the uric acid level increased from 305.6 ±64.15?mol/L to 329.36±69.56 ?mol/L,and the uric acid change value(? UA)was23.76±15.74 ?mol/L.There was a statistical difference in the change of uric acid level between before and after medication(P <0.05);The uric acid in the observation waiting changed from 303.41 ± 53.69?mol/L to 308.24±52.19 ?mol/L,and ? UA was4.83±3.92 ?mol/L.There was no statistical difference in uric acid level between before and after follow-up(P >0.05).There was a statistically significant difference in the ? UA between the aspirin prevention group and the observation waiting group(P<0.05).2.The uric acid level of patients in the aspirin group increased from 303.57 ± 61.46?mol/L to 343.19±55.78 ?mol/L,and ? UA was 39.62±12.09?mol/L.There was significant difference in uric acid level between before and after taking the drug(P<0.05).The uric acid level of clopidogrel group increased from 305.42 ± 63.29 ?mol/L to 311.87 ± 67.11 ?mol/L,and ? UA was 6.45 ± 2.95?mol/L.There was no significant difference in uric acid level between before and after taking the drug(P >0.05).There was a statistically significant difference in the ? UA between the aspirin group and the clopidogrel group(P <0.05).3.The creatinine in the aspirin prevention group increased from 76.64 ± 19.72mmol/L to 86.77±17.79mmol/L,and the glomerular filtration rate(GFR)decreased from86.46 ± 23.04min/L to 74.28±19.46ml/ min,creatinine change value(? Cr)was10.13±8.24mmol/L,glomerular filtration rate change value(? GFR)was12.32±8.24ml/min,and there were statistics difference of creatinine and glomerular filtration rate before and after treatment(P <0.05);the creatinine in the observation waiting group changed from 70.16 ± 13.608mmol/L to 73.87±15.13mmol/L,and the GFR changed from 87.56 ± 20.90ml/min to 81.50±20.31ml/min,and ?Cr was 3.71 ±1.92mmol/L,?GFR was 6.06±2.73ml/min.There was no significant difference in the changes of creatinine and glomerular filtration rate between before and after follow-up(P >0.05).4.The creatinine of patients with high uric acid increased from 72.24 ± 19.72mmol/L to 91.04±19.81mmol/L,and the GFR decreased from 84.09±22.31min/L to70.37±17.13ml/min,and ?Cr was 18.80±9.75mmol/L.?GRF was 13.72±6.54mmol/L.There was significant difference in creatinine and glomerular filtration rate between before and after medication(P <0.05).In patients with normal acid,creatinine increased from 70.94 ± 18.54mmol/L to 79.25±14.92 mmol/L,GFR decreased from83.85±20.84min/L to 77.78±21.07ml/min,?Cr was 8.31±6.13mmol/L,?GFR was6.07±5.73ml/min,creatinine and glomerular filtration before and after administration There was a statistically significant difference in the rate(P >0.05).In the clopidogrel group,the creatinine increased from 71.12 ± 17.93mmol/L to 80.29±18.33 mmol/L,and the GFR decreased from 87.56 ± 20.90 ml/min to 80.33± 20.22ml/min.Cr was9.17±5.98mmol/L,?GFR was 7.23±4.73ml/min.There was no significant difference in the changes of creatinine and glomerular filtration rate between before and after medication(P >0.05).Comparison of high uric acid group and normal uric acid There were statistically significant differences between the groups of ? Cr and ? GFR(P<0.05).There was no significant difference in ? Cr and ? GFR between the normal acid group and the clopidogrel group(P >0.05).Conclusions:1.Long-term use of low-dose aspirin can cause elevated blood uric acid levels.This phenomenon can be seen not only in patients with primary prevention of cardiovascular events,but also in patients after coronary stenting.The effect of clopidogrel on uric acid metabolism was not significant.2.Among patients with coronary heart disease who take aspirin for a long time after stent implantation to prevent restenosis and other adverse prognosis,patients with abnormal uric acid metabolism are at greater risk of later renal function decline.. |
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