title: Frequency, risk factors, prognosis, and genetic polymorphism of the cyclooxygenase-1 gene for aspirin resistance in elderly Chinese patients with cardiovascular disease.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is an important cause of mortality in elderly patients worldwide. Aspirin resistance has been well reported in CVD.
  
  
  OBJECTIVE
  The frequency, risk factors, prognosis, and genetic polymorphism of the cyclooxygenase-1 (COX-1) gene for aspirin resistance have not been reported in elderly patients with CVD. We therefore undertook this study to evaluate these associations among elderly Chinese patients with CVD.
  
  
  METHODS
  Four hundred thirty-one elderly Chinese patients with CVD receiving daily aspirin therapy (≥75 mg) over 1 month were enrolled. Platelet aggregation was measured by light transmission aggregometry (LTA) and thromboelastography platelet mapping assay (TEG) using arachidonic acid (AA) as a stimulus. The median follow-up was 1.8 years.
  
  
  RESULTS
  After the median follow-up, aspirin-resistant patients were at an increased risk of the composite endpoint compared to nonresistant patients by LTAAA + TEGAA (23.7 vs. 9.2%, p = 0.025). Additionally, Cox proportional hazards regression modeling demonstrated that aspirin resistance and cerebrovascular disease were associated with major adverse long-term outcomes (HR for aspirin resistance = 2.31, 95% CI 1.11-4.81, p = 0.026). The variant G-allele of COX-1 rs1330344 (-1676 A/G) significantly increased the risk of aspirin resistance defined by LTAAA + TEGAA (OR = 1.82, 95% CI 1.13- 2.92, p = 0.01).
  
  
  CONCLUSIONS
  Aspirin resistance, evaluated by LTAAA + TEGAA, is associated with an increased risk of adverse clinical events in elderly Chinese patients with CVD. The variant G-allele of COX-1 rs1330344 is significantly associated with aspirin resistance defined by LTAAA + TEGAA.
authors.affiliation: Clinical Department of South Building, Chinese PLA General Hospital, Beijing, PR China. calvin301@163.com
authors.forename: Li
authors.initials: L
authors.lastname: Fan
authors.forename: Jian
authors.initials: J
authors.lastname: Cao
authors.forename: Lin
authors.initials: L
authors.lastname: Liu
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Li
authors.forename: Guoliang
authors.initials: G
authors.lastname: Hu
authors.forename: Yixin
authors.initials: Y
authors.lastname: Hu
authors.forename: Bingpo
authors.initials: B
authors.lastname: Zhu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000235:genetics; D001241:Aspirin / Q000494:pharmacology* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D002681:China; D051545:Cyclooxygenase 1 / Q000187:drug effects / Q000235:genetics*; D004351:Drug Resistance / Q000235:genetics*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D020641:Polymorphism, Single Nucleotide; D016016:Proportional Hazards Models; D013916:Thrombelastography; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D051545:Cyclooxygenase 1; C496511:PTGS1 protein, human; D001241:Aspirin