Aspirin resistance.

Acetylsalicylic acid, is one of the most effective antiplatelet agents. It effectively reduces the risk of thrombotic events across wide spectrum of patients with cardiovascular disease. However, the treatment failures are relatively common and significant number of patients don't benefit from aspirin therapy. In the last decade the term "aspirin resistance" has been used to describe several different phenomena. This article exposes the difficulties in defining aspirin resistance, discusses the mechanisms by which resistance may occur and deals with its clinical impact. It is necessary to standardize a definition of aspirin resistance, to develop reliable tests for it, and to assess the clinical utility of testing on patients outcomes (Tab. 3, Ref. 60).

[Relation of polymorphism of genes controlling endothelial function and blood pressure and the occurrence of vascular complications in type 2 diabetes]. / Vzt'ah polymorfizmov génov ovplyvnujúcich funkciu endotelu a krvný tlak k výskytu vaskulárnych komplikácií pri diabete 2. typu.

Genetic polymorphisms of factors regulating the function of endothelium and blood pressure are recently intensively studied also in type 2 diabetes because endothelial dysfunction and arterial hypertension are risk factors of atherosclerosis. The following review deals with relations of polymorphisms in the renin-angiotensin-aldosterone (RAAS) system, polymorphisms of NO-synthase (NOS) as well as the gene for atrial natriuretic peptide (hANP). So far most information was assembled on the influence of polymorphisms of RAAS genes, in particular the gene coding the angiotensin converting enzyme (ACE), on complications of type 2 diabetes. A relationship with the development of coronary disease was described in ACE genes, the receptor for angiotensin II--type 1 (AT1R), angiotensinogen and in several NOS polymorphisms. Also the relationship of polymorphisms of genes ACE, AT1R, NOS and hANP was described in relation to the development of hypertension which is an important risk factor for macrovascular and microvascular complications of diabetes. In some investigations the relationship of polymorphisms of ACE and AT1R genes and the development of diabetic nephropathy was described where a significant acceleration of the process of atherogenesis occurs. As type 2 diabetes mellitus and atherosclerosis are polygenically determinal diseases, it will be in particular necessary to investigate in future the concurrent influence of several gene polymorphisms and their interactions with the diabetic milieu intérieur on the development of macrovascular and microvascular complications of diabetes.