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Objective To quantify the risk factors for aspirin resistance so as to increase the prognosis for risk of coronary heart disease,and to establish a predictive model for aspirin resistance in order to guide the clinical anti-platelet therapy.Methods A total of 938 elderly male patients with stable coronary heart disease (CHD) receiving oral aspirin therapy (＞75 mg/d) over 2 months were included in this study.Their clinical data were collected.Logistic regression analysis was performed to establish a predictive model and risk score for aspirin resistance.Hosmer Lemeshow (H-L) test and an area under the receiver operating characteristic (ROC) curve (the area under the ROC curve) were performed to test the calibration and discrimination of the model.Results Seven risk factors were included in the predictive model,including serum creatinine (＞110 μmol/L:score of 1),fasting blood glucose (＞7.0 mmol/L:score of 1),hyperlipidemia (score of 1),number of coronary arteries in lesion (2 branches:score of 2,≥≥3 branches:score of 4),body mass index[(20-25) kg/m2:score of 2,＞25 kg/m2:score of 4],percutaneous coronary intervention (score of 2),smoking (score of 3).H-L test showed P≥0.05 and the area under the ROC curve＞0.70 in this model.Conclusions the risk factors for aspirin resistance,and establishing a valid predictive model for aspirin resistance,could provide an important reference for anti-platelet therapy in CHD patients.
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Objective Although aspirin resistance has been recognized to occur in patients with diabetes mellitus, the prevalence and related risk factors for aspirin resistance in elderly patients with diabetes mellitus have not been reported yet. The purpose of the present study was to evaluate the prevalence and potential risk factors for aspirin resistance in elderly patients with type 2 diabetes.Methods The 140 elderly patients [aged from 60 to 92 years, mean age (73.8±8. 0) years] with type 2 diabetes receiving daily aspirin therapy (≥ 75 mg) over one month were recruited. Platelet aggregation was measured by light transmittance aggregometry (LTA) and thrombelastograph (TEG)platelet mapping assay. Results By LTA, 6 patients (4.3%) of the diabetic patients were found to be resistant to aspirin therapy, 44 patients (31.4 %) were semi-responders. By TEG, 31 patients (22. 1%) were aspirin resistant. Among the 31 patients who were aspirin resistant by TEG, 3 were aspirin resistant by LTA. In the multivariate logistic regression analysis, female gender (OR= 5. 54,95%CI: 1.17-27.47, P=0.036) and homocysteine level (OR=1.15, 95%CI: 1.00-1.35, P=0. 043) were statistically significant risk factors for aspirin resistance by TEG. Conclusions The prevalence of aspirin resistance in elderly patients with type 2 diabetes is considerably higher in elderly female patients and in elderly patients with higher serum homocysteine level.
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Objective The sex hormone and the corresponding receptor may play some roles in the development of the metabolic syndrome (MS) in the elderly men.This study was designed to examine the relationship of level of the sex hormone and androgen receptor with MS in elderly men,thus to investigate the possible pathogenesis of MS.Methods This cross sectional study enrolled 587 elderly men,including 400 healthy controlls aged 62-92 years and 187 MS patients aged 60-87 years in Wan Shou Lu area of Beijing city.Dehydroepiandrosterone sulfate (DHAE-S),total testosterone (TT),sex hormone binding globulin (SHBG),free testosterone (FT),follicle-stimulating hormone (FSH),Estradiol (E2),luteinizing hormone(LH) and androgen receptor (AR) in blood were tested.Statistical analyses included the comparison analysis of variables and independent variables,correlation analysis using multi-factor linear regression,and multiple logistic regression analysis.Results DHAE-S,TT,SHBG,FT and AR fluorescence intensity in healthy control group were higher than those in MS group,however,FSH and E2 levels were lower in healthy group.Age was negatively correlated with diastolic blood pressure (DBP) and FT,but positively correlated with systolic blood pressure (SBP) and E2.AR fluorescence intensity was negatively correlated with SBP and LH.The logistic regression equation showed the negative correlation between DHEA-S,SHBG and the development of MS.Conclusions There are low levels of DHEA-S,TT,SHBG,FT and AR in the elderly patients with MS.On the contrary,FSH and E2 concentration are higher.It can be suggested that low levels of DHEA-S and SHBG may be the potential risk factors of MS in elderly men.