Laboratory efficacy testing of acetylsalicylic acid treatment in secondary prevention of ischemic stroke

Czech version

Authors: T. Adámek ¹; Z. Paluch ²; L. Sadílková ¹; Š. Alušík ³
Authors‘ workplace: Interní oddělení, Thomayerova nemocnice, Praha ¹; Ústav farmakologie, 2. LF UK, Praha ²; Katedra vnitřního lékařství, Institut postgraduálního vzdělávání ve zdravotnictví, Praha ³
Published in: Cesk Slov Neurol N 2019; 82(1): 84-90
Category: Original Paper

Overview

Aim:

To assess the efficacy of antiplatelet therapy with acetylsalicylic acid (ASA) in secondary prevention in a strictly selected group of patients after ischemic stroke.

Patients and methods:

The group included 106 patients with a minimum of factors potentially affecting the effect of ASA. While compliance was verified by laboratory determination of ASA levels in plasma, presence of previous embolic events was minimized by thorough examination of the heart and carotid arteries. All patients taking 100 mg of ASA daily had their serum 11-dehydrotromboxane B2 levels determined.

Results:

Even in this strictly selected set of patients, effective thromboxane suppression (95% and higher) was only achieved in 76 patients, with suppression levels of 80– 94.9% determined in 24 patients, and lower in another six patients. Patients with inadequate thromboxane suppression had statistically higher body mass index, cholesterol and LDL cholesterol, and uric acid levels.

Conclusion:

While ASA use led to marked thromboxane suppression in all patients, the required level of suppression was not achieved in over a fourth of our patients. Consistent with latest reports, it is likely that the seemingly inadequate suppression of thromboxane is due to its production from sources other than platelets.

Key words:

acetylsalicylic acid – ischemic stroke – 11-dehydrothromboxane

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

乙酰水杨酸治疗缺血性脑卒中的实验室疗效试验

目的:

目的:评价乙酰水杨酸(ASA)抗血小板治疗在缺血性脑卒中后二级预防中的作用。

患者和方法:

本组纳入106例患者，其中影响ASA疗效的因素最少。虽然通过实验室测定血浆中ASA水平证实了依从性，但通过对心脏和颈动脉的彻底检查，以前的栓塞事件的存在被最小化。所有每天服用100毫克ASA的患者的血清中11-脱氢托姆波塞烷B2水平被测定。

结果:

即使在这组严格选择的患者中，有效的血栓素抑制(95%及以上)仅在76例患者中实现，其中24例患者的抑制水平为80 - 94.9%，另外6例患者的抑制水平较低。血栓素抑制不足的患者，其体重指数、胆固醇和低密度脂蛋白胆固醇以及尿酸水平均有统计学意义上的升高。

结论:

虽然ASA的使用导致所有患者血栓素明显抑制，但超过四分之一的患者没有达到所需的抑制水平。与最新的报道相一致，血栓素的抑制作用似乎并不充分，这可能是由于血栓素不是由血小板产生的。

关键词:

乙酰水杨酸-缺血性脑卒中- 11-脱氢血栓素

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