| Objective:Aspirin as an antiplatelet therapy is still the cornerstone of the treatment of ischemic cardio-cerebrovascular diseases.In recent years,studies have reported that about 5%-65% of patients with ischemic cardiovascular and cerebrovascular diseases taking aspirin have a low drug response to aspirin,which is called "aspirin resistance(AR)".AR is closely related to the recurrence of ischemic cardiovascular and cerebrovascular events.In clinical practice,it is of great clinical significance to closely follow up and detect the presence of AR in oral aspirin patients.Studies have reported that platelet functional parameters(such as platelet,mean platelet volume,etc.)can be used as a predictor of ischemic cardiac events.Subsequently,some scholars have pointed out that AR and platelet functional parameters may be correlated.In this study,we used thrombelastography(TEG)to detect the presence of AR in patients with ischemic cardio-cerebrovascular disease,and to investigate the correlation between platelet function parameters and AR.Methods:A total of 122 patients diagnosed with cerebral infarction and coronary atherosclerotic heart disease in Jiangxi Provincial People’s Hospital from January2019 to January 2020 were included in this study.All patients took aspirin for at least 7 days(100mg daily load dose),and performed thrombelastography(TEG)in our hospital.Follow up the electronic records of patients in hospital,improve the collection of basic clinical data and clinical laboratory data.AR was defined according to the degree of platelet inhibition in TEG.AR was defined as the inhibition rate of arachidonic acid(AA)less than 50%.The patients were divided into AR group and non-AR(no aspirin resistance,NAR)group.Through independent sample t test,Mann-Whitney U test,χ2 test,Fisher test,multi-element Logistic regression analysis and receiver operating characteristic,ROC)curve analysis to determine the correlation between platelet functional parameters and AR.Results:(1)88(72%)of the 122 patients were diagnosed with AR.Mean platelet volume(MPV)and diabetes prevalence in AR group were higher than those in NAR group(P<0.05).The level of uric acid(UA)in AR group was lower than that in NAR group(P<0.05).(2)Multivariate logistic regression analysis showed that MPV level(OR: 1.49,95%CI: 1.02-2.20,P =0.042)and diabetes mellitus(OR: 2.71,95%CI: 1.10-7.00,P=0.041)were independently and significantly correlated with AR.(3)The results of ROC curve showed that when predicting AR,the optimal cut-off value of MPV was 11.65 fL,the sensitivity was 76.5%,the specificity was55%,and the area under curve(AUC)was 0.611.Conclusion:(1)This study showed that in patients with ischemic cardio-cerebrovascular diseases,the MPV level and the incidence of diabetes in the AR group were higher than those in the NAR group,while the uric acid(UA)level in the AR group was lower than that in the NAR group,with statistically significant differences.(2)This study showed that high MPV level and diabetes were independent risk factors for AR in patients with ischemic cardio-cerebrovascular diseases.(3)This study indicated that the level of MPV as a prediction and screening index of AR has certain clinical significance. |
