Aspirin Resistance in Thai Patients with Chronic Stable Angina
Rewat Phankingthongkum MD*, Pradit Panchavinnin MD*, Yingyong Chinthammitr MD**, Damras Tresukosol MD*, Chunhakasem Chotinaiwattarakul MD*, Wiwun Tungsubutra MD*, Nattawut Wongpraparut MD*, Dararat Karevee RN***, Sumalee Chansaeng PN*
Affiliation : * Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Division of Hematology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand *** Her Majestry’s Cardiac Center, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine the prevalence, clinical profile and risk factors of aspirin resistance in Thai patients with chronic
stable angina.
Material and Method: The patients were prospectively recruited from the consecutive patients diagnosed chronic stable
angina at Siriraj Hospital during March 2011 to February 2012. Ten milliliter of blood samples were cautiously drawn from
the antecubital vein of the patients to determine the hemoglobin, platelet count and platelet aggregation test performed by light
transmittance aggregometry using platelet-rich plasma. Platelets were stimulated with 0.5 mg/ml of arachidonic acid and 10
mM adenosine diphosphate. Platelet aggregation was expressed as the maximal percent change in light transmittance from
baseline. Aspirin resistance was defined as the mean platelet aggregation of > 70% with 10 mM ADP and the mean platelet
aggregation of > 20% with 0.5 mg/ml of arachidonic acid.
Results : One-hundred and fifty seven patients diagnosed chronic stable angina were enrolled in the present study. There were
34 patients (21.6%) demonstrating aspirin resistance. The clinical characteristic of these patients included male 58.8% with
mean age of 66 years, body mass index 27.5 kg/m2, diabetes mellitus 52.9%, smoking 8.8%, hypercholesterolemia 70.6%
and proton pump inhibitor use 23.5%. Multivariate analysis demonstrated none of the risk factors including age, female,
body mass index, diabetes mellitus, hypercholesterolemia, smoking and proton pump inhibitor (PPI) use had a statistically
significant association with aspirin resistance.
Conclusion : Our study demonstrated that the prevalence of aspirin resistance in Thai patients with chronic stable angina
was 21.6%. No significant association was demonstrated between age, female, body mass index, diabetes mellitus,
hypercholesterolemia, smoking, proton pump inhibitor (PPI) use and aspirin resistance.
Keywords : High on-treatment platelet reactivity, Aspirin resistance, Aspirin non-responsiveness, Aspirin, Platelet aggregation
