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Aspirin resistance: is this term meaningful?

机译：阿司匹林耐药性：这个术语有意义吗？

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摘要

PURPOSE OF REVIEW: To review data for and against the existence of 'aspirin resistance', a term coined to indicate aspirin-treated patients having ex-vivo tests of platelet activation insensitive to aspirin treatment and recurrence of cardiovascular disease. RECENT FINDINGS: 'Aspirin resistance' defined by ex-vivo tests of platelet activation yielded values ranging from 21 to 78%, indicating that such tests do not provide a useful measurement. In long-term aspirin-treated patients, studies demonstrated small but functionally relevant platelet thromboxane A2 formation that was responsible for an enhanced platelet activation in response to platelet agonist. These studies, however, did not fully exclude that aspirin compliance may be implicated in such phenomena. Two trials performed in patients with coronary artery disease demonstrated that laboratory evidence of aspirin resistance was no longer detectable when aspirin compliance was accurately monitored. SUMMARY: Given the multifactorial nature of atherothrombosis, recurrence of cardiovascular events in aspirin-treated patients does not necessarily suggest 'drug failure'. A cause-effect relationship between platelet insensitivity to aspirin and cardiovascular recurrence has not been defined overall because aspirin compliance has been scarcely considered. Until this information is taken into account, the existence of 'clinical resistance' to aspirin should be reconsidered.
机译：审查目的：审查有关“阿司匹林抗药性”存在与否的数据，该术语专门用来表示接受阿司匹林治疗的患者体内进行了对阿司匹林治疗和心血管疾病复发不敏感的血小板活化试验。最近的发现：血小板活化的体外试验所定义的“阿司匹林抗性”的值范围为21％至78％，表明此类试验无法提供有用的测量结果。在长期接受阿司匹林治疗的患者中，研究表明，血小板小而功能相关的血小板血栓烷A2的形成与血小板激动剂的响应引起了血小板活化的增强。但是，这些研究并未完全排除阿司匹林依从性可能与此类现象有关。在冠心病患者中进行的两项试验表明，准确监测阿司匹林依从性后，再也无法检测到阿司匹林耐药性的实验室证据。摘要：鉴于动脉粥样硬化血栓形成的多因素性质，在阿司匹林治疗的患者中心血管事件的复发不一定表明“药物衰竭”。血小板对阿司匹林不敏感与心血管疾病复发之间的因果关系尚未整体确定，因为很少考虑阿司匹林的依从性。在考虑这些信息之前，应重新考虑对阿司匹林的“临床耐药性”。

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