[Study on the relationship between aspirin resistance and incidence of myonecrosis after non-emergent percutaneous coronary intervention].
OBJECTIVE
To investigate the occurrence of aspirin resistance in coronary heart disease (CHD) patients and its influence on myonecrosis among patients undergoing non-emergent percutaneous coronary intervention (PCI).


METHODS
256 CHD patients who have been on aspirin (100 mg/d) for at least 7 days were recruited based on aspirin responsiveness determination. All the patients were divided into two groups: aspirin-resistant group and aspirin-sensitive group. For all patients scheduled for non-emergent PCI, a loading dose of 300 mg of clopidogrel was given at least 12 h before PCI and a 75 mg maintenance dose was given every morning before and after PCI. The incidence of myonecrosis was evaluated by the levels of creatine kinase-myocardial band (CK-MB) and troponin I (TnI) before and after PCI.


RESULTS
Aspirin resistance was found in 67 (26.2%) patients and 189 (73.8%) patients were aspirin-sensitive. There was a significantly higher proportion of female subjects in the aspirin-resistant group. The incidence of any CK-MB elevation was 38 (56.7%) in aspirin-resistant group and 42 (22.2%) in aspirin-sensitive group (P < 0.01). The elevation of TnI was observed in 41 (61.2%) of the aspirin-resistant group and in 67 (35.4%) of the aspirin-sensitive group (P < 0.05). Multivariate analysis revealed that aspirin resistance was an independent predictor for CK-MB elevation after PCI (OR = 2.5; 95% CI 1.5 to 6.5; P < 0.05).


CONCLUSIONS
Aspirin resistance exists in some CHD patients, which increases the risk of myonecrosis following non-emergent PCI.
Zhang
Yan
Y
Twelfth Ward, Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China.
Liang
Jing
J
Zhou
Yu-jie
YJ
Yuan
Hui
H
Zhang
Yong-zhi
YZ
Dong
Lei
L
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001241:Aspirin / Q000494:pharmacology / Q000627:therapeutic use*; D003327:Coronary Disease / Q000628:therapy*; D052279:Creatine Kinase, MB Form / Q000032:analysis; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000473:pathology*; D009336:Necrosis; D015539:Platelet Activation; D010974:Platelet Aggregation; D015607:Stents; D019210:Troponin I / Q000032:analysis
D019210:Troponin I; D052279:Creatine Kinase, MB Form; D001241:Aspirin