Relationship between carotid intima-media thickness and aspirin resistance in patients with stable coronary artery disease / 西安交通大学学报(医学版)

ABSTRACT

Objective: To explore the relationship between carotid intima-media thickness (IMT) and aspirin resistance (AR) in patients with stable coronary artery disease (SCAD). Methods: A total of 316 SCAD patients were enrolled and divided into 3 groups according to IMT measured by carotid artery ultrasound normal group (n=80), atherosclerosis group (n=102), and plaque group (n=134). Thrombelastogram instrument (TEG) was used to detect platelet aggregation rate (PAG) according to the level of PAG induced by adenosine diphosphate (ADP) to determination AR. The correlation between PAG level (ADP-PAG) and various factors was analyzed, and Logistic regression was used to analyze the risk factors for AR in SCAD patients. Results: The ADP-PAG level was higher in plaque group than in atherosclerosis group and normal group (59.12±11.44 vs. 53.34±10.78 vs. 49.58±11.62, P<0.01); the incidences of AR and aspirin semi-resistance were both higher than those in the other two groups. After adjustment for age and other factors, Logistic regression analysis showed that age (OR=4.08), female (OR=5.06), carotid atherosclerosis (OR=3.57) and carotid plaque (OR=6.35) were independent risk factors for predicting AR in SACD patients (P<0.05). ROC curve analysis revealed that the optimal cutoff of IMT to predict AR in SCAD patients was 1.95 mm, the sensitivity was 86.3%, the specificity was 62.9%, and the area under curve was 0.762 (95% CI 0.670-0.853, P<0.01). Conclusion: Carotid atherosclerosis is closely related to aspirin resistance in patients with SCAD, and it is an independent risk factor for AR.