ABSTRACT
Objective To investigate the incidence of the aspirin resistance in secondary prevention of cerebral infarction, and the relationship between the aspirin resistance and the cerebral infarction recurrence or other vascular events during the follow-up periods.Methods Aspirin were taken from the first day of admission in 600 patients with cerebral infarction.The platelet aggregation rate was measured after 7-10 days to screen the patients with aspirin resistance or aspirin sensitivity.All patients were followed up for 6 to 24 months and the cerebral infarction recurrence and other vascular events were recorded.Logistic regression model was used to estimate the risk factors of aspirin resistance, vascular events and prognosis.Results Of 600 patients, 150 (25.0% ) patients were resistant to aspirin and 450 (75.0% ) patients were sensitive to aspirin.The proportion of female and diabetes patients, and the level of low density lipoproteins (LDL) in the aspirin resistance group were higher than those in the aspirin sensitivity group.Diabetes (OR = 2.58, 95% CI 1.37-4.85, P=0.003) and high LDL level (OR = 1.89, 95% CI 1.21-2.93, P = 0.005 ) were independent risk factors of aspirin resistance.The incidence of cerebral infarction recurrence and myocardial infarction and all-cause mortality in the aspirin resistance group were all higher than those in the aspirin sensitivity group.Diabetes ( OR = 2.47, 95% CI 1.36-4.65, P = 0.003 ) , atherothrombosis cerebral infarction (OR = 2.13, 95% CI 1.24-3.95, P = 0.023) and aspirin resistance (OR = 3.86,95% CI 1.79-5.87, P = 0.002) were independent risk factors of vascular events during the following-up period.In the patients with aspirin resistance, the risk of the recurrence of vascular events increased 3.86 times.Conclusions The incidence of aspirin resistance is high in secondary prevention of cerebral infarction.Aspirin resistance is closely correlated with cerebral infarction recurrence and other vascular events.
ABSTRACT
Objective: To compare the effectiveness and security of instant single intravesical instillation of pirarubicin and multiple instillations at two weeks after transurethral resection of bladder tumor (TUR-Bt) for prevention of non muscle-invasive bladder cancer recurrence. Methods: We recruited 162 non muscle-invasive bladder cancer patients from Mar 2003 to Jun 2005. They were randomly divided into 2 groups: 80 cases received instant single intravesical instillation of pirarubicin post operation (group RG) and 82 cases were given multiple intravesical perfusions of pirarubicin regularly after two weeks of operation (group CG). The recurrence rates and side effects between the two groups were compared. Results: Totally six patients lost follow-up. The two groups both had 78 valid follow-up cases. The follow-up period was 24 to 48 months. The recurrence rate was 25.6% (20/78) in group RG, and 17.9% (14/78) in group CG. There was no significant difference between the two groups. The recurrence rates of G2 and G3 tumor were 42.5% (17/40) in group RG, and 20.9% (9/43) in group CG. The recurrence rate of group CG was lower than that in group RG in subset tumor at higher grade (G2 and G3). Conclusion: The total effectiveness of instant single intravesical instillation of chemotherapy is similar to multiple instillations of chemotherapy after two weeks of TUR-Bt for preventing the recurrence of non muscle-invasive bladder cancer. But multiple instillations can better decrease the recurrence of non muscle-invasive bladder cancer at higher pathological grade (G2 and G3).