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| 1 | Clinical importance of aspirin and clopidogrel resistance显示文摘Aspirin and clopidogrel are important components of medical therapy for patients with acute coronary syndromes, for those who received coronary artery stents and in the secondary prevention of ischaemic stroke. Despite their use, a significant number of patients experience recurrent adverse ischaemic events. Interindividual variability of platelet aggregation in response to these antiplatelet agents may be an explanation for some of these recurrent events, and small trials have linked 'aspirin and/or clopidogrel resistance', as measured by platelet function tests, to adverse events. We systematically reviewed all available evidence on the prevalence of aspirin/clopidogrel resistance, their possible risk factors and their association with clinical outcomes. We also identified articles showing possible treatments. After analyzing the data on different laboratory methods, we found that aspirin/clopidogrel resistance seems to be associated with poor clinical outcomes and there is currently no standardized or widely accepted definition of clopidogrel resistance. Therefore, we conclude that specific treatment recommendations are not established for patients who exhibit high platelet reactivity during aspirin/clopidogrel therapy or who have poor platelet inhibition by clopidogrel. | Gergely Feher Andrea Feher Gabriella Pusch Katalin Koltai Antal Tibold Beata Gasztonyi Elod Papp Laszlo Szapary Gabor Kesmarky Kalman Toth | 2010 | World Journal of Cardiology2010，2，7： | 36 |
| 2 | Clinical features of gastroduodenal injury associated with long-term low-dose aspirin therapy显示文摘Low-dose aspirin(LDA) is clinically used for the prevention of cardiovascular and cerebrovascular events with the advent of an aging society.On the other hand,a very low dose of aspirin(10 mg daily) decreases the gastric mucosal prostaglandin levels and causes significant gastric mucosal damage.The incidence of LDAinduced gastrointestinal mucosal injury and bleeding has increased.It has been noticed that the incidence of LDA-induced gastrointestinal hemorrhage has increased more than that of non-aspirin non-steroidal anti-inflammatory drug(NSAID)-induced lesions.The pathogenesis related to inhibition of cyclooxygenase(COX)-1 includes reduced mucosal flow,reduced mucus and bicarbonate secretion,and impaired platelet aggregation.The pathogenesis related to inhibition of COX-2 involves reduced angiogenesis and increased leukocyte adherence.The pathogenic mechanisms related to direct epithelial damage are acid back diffusion and impaired platelet aggregation.The factors associated with an increased risk of upper gastrointestinal(GI) complications in subjects taking LDA are aspirin dose,history of ulcer or upper GI bleeding,age > 70 years,concomitant use of non-aspirin NSAIDs including COX-2-selective NSAIDs,and Helicobacter pylori(H.pylori) infection.Moreover,no significant differences have been found between ulcer and non-ulcer groups in the frequency and severity of symptoms such as nausea,acid regurgitation,heartburn,and bloating.It has been shown that the ratios of ulcers located in the body,fundus and cardia are significantly higher in bleeding patients than the ratio of gastroduodenal ulcers in patients taking LDA.Proton pump inhibitors reduce the risk of developing gastric and duodenal ulcers.In contrast to NSAIDinduced gastrointestinal ulcers,a well-tolerated histamine H2-receptor antagonist is reportedly effective in prevention of LDA-induced gastrointestinal ulcers.The eradication of H.pylori is equivalent to treatment with omeprazole in preventing recurrent bleeding.Continuous aspirin therapy for patients with gastrointestinal bleeding may increase the risk of recurrent bleeding but potentially reduces the mortality rates,as stopping aspirin therapy is associated with higher mortality rates.It is very important to prevent LDA-induced gastroduodenal ulcer complications including bleeding,and every effort should be exercised to prevent the bleeding complications. | Junichi Iwamoto Yoshifumi Saito Akira Honda Yasushi Matsuzaki | 2013 | World Journal of Gastroenterology2013，19，11： | 29 |
| 3 | 氯吡格雷稳定易损斑块显示文摘 | 王拥军 | 2005 | 国外医学(脑血管疾病分册)2005，13，10： | 21 |
| 4 | Mechanisms, prevention and clinical implications of nonsteroidal anti-inflammatory drug-enteropathy显示文摘This article reviews the latest developments in understanding the pathogenesis, detection and treatment of small intestinal damage and bleeding caused by nonsteroidal anti-inflammatory drugs (NSAIDs). With improvements in the detection of NSAID-induced damage in the small intestine, it is now clear that this injury and the associated bleeding occurs more frequently than that occurring in the stomach and duodenum, and can also be regarded as more dangerous. However, there are no proven-effective therapies for NSAID-enteropathy, and detection remains a challenge, particularly because of the poor correlation between tissue injury and symptoms. Moreover, recent studies suggest that commonly used drugs for protecting the upper gastrointestinal tract (i.e., proton pump inhibitors) can significantly worsen NSAID-induced damage in the small intestine. The pathogenesis of NSAID-enteropathy is complex, but studies in animal models are shedding light on the key factors that contribute to ulceration and bleeding, and are providing clues to the development of effective therapies and prevention strategies. Novel NSAIDs that do not cause small intestinal damage in animal models offer hope for a solution to this serious adverse effect of one of the most widely used classes of drugs. | John L Wallace | 2013 | World Journal of Gastroenterology2013，19，12： | 15 |
| 5 | Platelet thromboxane(11-dehydro-Thromboxane B_2) and aspirin response in patients with diabetes and coronary artery disease显示文摘Aspirin(ASA) irreversibly inhibits platelet cyclooxygenase-1(COX-1) leading to decreased thromboxane-mediated platelet activation. The effect of ASA ingestion on thromboxane generation was evaluated in patients with diabetes(DM) and cardiovascular disease. Thromboxane inhibition was assessed by measuring the urinary excretion of 11-dehydro-thromboxane B2(11dhTxB2), a stable metabolite of thromboxane A2. The mean baseline urinary 11dhTxB2 of DM was 69.6% higher than healthy controls(P = 0.024): female subjects(DM and controls) had 50.9% higher baseline 11dhTxB2 than males(P = 0.0004), while age or disease duration had no influence. Daily ASA ingestion inhibited urinary 11dhTxB2 in both DM(71.7%) and controls(75.1%, P < 0.0001). Using a pre-established cut-off of 1500 pg/mg of urinary 11dhTxB2, there were twice as many ASA poor responders(ASA 'resistant') in DM than in controls(14.8% and 8.4%, respectively). The rate of ASA poor responders in two populations of acute coronary syndrome(ACS) patients was 28.6 and 28.7%, in spite of a significant(81.6%) inhibition of urinary 11dhTxB2(P < 0.0001). Both baseline 11dhTxB2 levels and rate of poor ASA responders were significantly higher in DM and ACS compared to controls. Underlying systemic oxidative inflammation may maintain platelet function in atherosclerotic cardiovascular disease irrespective of COX-1 pathway inhibition and/or increase systemic generation of thromboxane from non-platelet sources. | Luis R Lopez Kirk E Guyer Ignacio Garcia De La Torre Kelly R Pitts Eiji Matsuura Paul RJ Ames | 2014 | World Journal of Diabetes2014，5，2： | 13 |
| 6 | Current status of high on-treatment platelet reactivity in patients with coronary or peripheral arterial disease:Mechanisms,evaluation and clinical implications显示文摘Antiplatelet therapy with aspirin or clopidogrel or both is the standard care for patients with proven coronary or peripheral arterial disease,especially those undergoing endovascular revascularization procedures. However,despite the administration of the antiplatelet regiments,some patients still experience recurrent cardiovascular ischemic events. So far,it is well documented by several studies that in vitro response of platelets may be extremely variable. Poor antiplatelet effect of clopidogrel or high on-treatment platelet reactivity(HTPR) is under investigation by numerous recent studies. This review article focuses on methods used for the ex vivo evaluation of HTPR,as well as on the possible underlying mechanisms and the clinical consequences of this entity. Alternative therapeutic options and future directions are also addressed. | Stavros Spiliopoulos Georgios Pastromas | 2015 | World Journal of Cardiology2015，7，12： | 13 |
| 7 | Aspirin alleviates endothelial gap junction dysfunction through inhibition of NLRP3inflammasome activation in LPS-induced vascular injury显示文摘The loss of endothelial connective integrity and endothelial barrier dysfunction can lead to increased vascular injury, which is related to the activation of endothelial inflammasomes. There are evidences that low concentrations of aspirin can effectively prevent cardiovascular diseases. We hypothesized that low-dose aspirin could ameliorate endothelial injury by inhibiting the activation of NLRP3 inflammasomes and ultimately prevent cardiovascular diseases. Microvascular endothelial cells were stimulated by lipopolysaccharide(2 μg/mL) and administrated by 0.1–2 mmol/L aspirin. The wild type mice were stimulated with LPS(100 μg/kg/day), and 1 h later treated with aspirin(12.5, 62.5, or125 mg/kg/day) and dexamethasone(0.0182 mg/kg/day) for 7 days. Plasma and heart were harvested for measurement of ELISA and immunofluorescence analyses. We found that aspirin could inhibit NLRP3 inflammasome formation and activation in vitro in dose-dependent manner and has correlation between the NLRP3 inflammasome and the ROS/TXNIP pathway. We also found that low-concentration aspirin could inhibit the formation and activation of NLRP3 inflammasome and restore the expression of theendothelial tight junction protein zonula occludens-1/2(ZO1/2). We assume that aspirin can ameliorate the endothelial layer dysfunction by suppressing the activation of NLRP3 inflammasome. | Xing Zhou Yanjiao Wu Lifeng Ye Yunting Wang Kaimin Zhang Lingjun Wang Yi Huang Lei Wang Shaoxiang Xian Yang Zhang Yang Chen | 2019 | Acta Pharmaceutica Sinica B2019，9，4： | 13 |
| 8 | Treatment and prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy显示文摘Antiplatelet therapy is the standard of care for the secondary prevention of acute coronary syndrome and ischemic stroke, especially after coronary intervention. However, this therapy is associated with bleeding complications such as gastrointestinal bleeding, which is one of the most common life-threatening complications. Early endoscopy is recommended for most patients with acute upper gastrointestinal bleeding. After successful endoscopic hemostasis, immediate resumption of antiplatelet therapy with proton-pump inhibitors(PPIs) is recommended to prevent further ischemic events. PPI prophylaxis during antiplatelet therapy reduces the risk of upper gastrointestinal bleeding. The potential negative metabolic interaction between PPIs and clopidogrel is still unclear. | Hiroshi Yasuda Yasumasa Matsuo Yoshinori Sato Sun-ichiro Ozawa Shinya Ishigooka Masaki Yamashita Hiroyuki Yamamoto Fumio Itoh | 2015 | World Journal of Critical Care Medicine2015，4，1： | 13 |
| 9 | Meta-analysis of aspirin-heparin therapy for un-explained recurrent miscarriage显示文摘Objective This study was designed to evaluate the efficacy and safety of aspirin-heparin treatment for un-explained recurrent spontaneous abortion(URSA). Methods Literatures reporting the studies on the aspirin-heparin treatment of un-explained recurrent miscarriage with randomized controlled trials(RCTs) were collected from the major publication databases. The live birth rate was used as primary indicator, preterm delivery, preeclampsia, intrauterine growth restriction, and adverse reactions(thrombocytopenia) were used as the secondary indicators. The quality of the included studies was evaluated using RCT bias risk assessment tool in the Cochrane Handbook(v5.1.0). Meta-analysis was conducted using RevM an(v5.3) software. Subgroup analyses were conducted with an appropriately combined model according to the type of the treatments if heterogeneity among the selected studies was detected. Results Six publications of RCTs were included in this study. There were a total of 907 pregnant women with diagnosis of URSA, 367 of them were pooled in the study group with aspirin-heparin therapy and 540 women in the control group with placebo, aspirin or progesterone therapy. Meta-analysis showed that the live birth rate in the study group was significantly different from that in the control group [RR = 1.18, 95% CI(1.00-1.39), P=0.04]. Considering the clinical heterogeneity among the six studies, subgroup analysis were performed. Live birth rates in the aspirin-heparin treated groups and placebo groups were compared and no significant difference was found. There were no significant differences found between the two groups in the incidence of preterm delivery [RR=1.22, 95% CI(0.54-2.76), P=0.64], preeclampsia [RR=0.52, 95% CI(0.25-1.07), P=0.08], intrauterine growth restriction [RR=1.19, 95% CI(0.56-2.52), P=0.45] and thrombocytopenia [RR=1.17, 95% CI(0.09-14.42), P=0.90]. Conclusion This meta-analysis did not provide evidence that aspirin-heparin therapy had beneficial effect on un-explained recurrent miscarriage in terms of live birth rate, but it was relatively safe for it did not increase incidence of adverse pregnancy and adverse events. More well-designed and stratified double-blind RCT, individual-based meta-analysis regarding aspirin-heparin therapy are needed in future. | Ling Tong Xian-jiang Wei | 2016 | Chinese Medical Sciences Journal2016，31，4： | 10 |
| 10 | Clopidogrel with aspirin in High- risk patients with Acute Non- disabling Cerebrovascular Events II (CHANCE-2): rationale and design of a multicentre randomised trial显示文摘Background In patients with a minor ischaemic stroke or transient ischaemic attack(TIA),separate trials have shown that dual antiplatelet therapy with clopidogrel plus aspirin(clopidogrel-aspirin)or ticagrelor plus aspirin(ticagrelor-aspirin)are more effective than aspirin alone in stroke secondary prevention.However,these two sets of combination have not been directly compared.Since clopidogrel was less effective in stroke patients who were CYP2C19 loss-of function(LOF)allele carriers,whether ticagrelor-aspirin is clinically superior to clopidogrel-aspirin in this subgroup of patients with stroke is unclear.Aim To describe the rationale and design considerations of the Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events(CHANCE-2)trial.Design CHANCE-2 is a randomised,double-blind,double-dummy,placebo-controlled,multicentre trial that compares two dual antiplatelet strategies for minor stroke or TIA patients who are CYP2C19 LOF allele carriers:ticagrelor(180 mg loading dose on day 1 followed by 90 mg twice daily on days 2-90)or clopidogrel(300 mg loading dose on day 1 followed by 75 mg daily on days 2-90),plus open-label aspirin with a dose of 75-300 mg on day 1 followed by 75 mg daily on day 2-21.All will be followed for 1 year.Study outcomes The primary efficacy outcome is any stroke(ischaemic or haemorrhagic)within 3 months and the primary safety outcome is any severe or moderate bleeding event within 3 months.Discussion The CHANCE-2 trial will evaluate whether ticagrelor-aspirin is superior to clopidogrel-aspirin for minor stroke or TIA patients who are CYP2C19 LOF allele carriers. | Yongjun Wang Claiborne Johnston Philip M Bath Xia Meng Jing Jing Xuewei Xie Anxin Wang Yuesong Pan Anding Xu Qiang Dong Yilong Wang Xingquan Zhao Zixiao Li Hao Li | 2021 | Stroke & Vascular Neurology2021，6，2： | 10 |
| 11 | Platelets in Kawasaki disease:Is this only a numbers game or something beyond?显示文摘Kawasaki disease(KD)is a medium vessel vasculitis with predilection to cause coronary artery abnormalities.KD is now the most common cause of acquired heart disease in developed countries.Thrombocytosis is consistently found in patients with KD,usually in 2nd to 3rd week of illness.Thrombocytopenia has occasionally been reported in the acute phase of KD.An increase or decrease in platelet number in patients with KD was initially considered to be a benign phenomenon.However,recent literature on platelet biology in KD has suggested that platelets are not only increasing but are rather activated.This phenomenon has been found to increase the risk of thrombosis in these patients.Similarly a fall in platelet counts during acute stage of KD has also been found to be associated with increased severity of disease.In this review,we update on the current best understanding about pathogenic role of platelets in patients with KD. | Kanika Arora Sandesh Guleria Ankur Kumar Jindal Amit Rawat Surjit Singh | 2020 | Genes & Diseases2020，7，1： | 9 |
| 12 | Aspirin, cyclooxygenase inhibition and colorectal cancer显示文摘Colorectal cancer(CRC)is the third most common type of cancer worldwide.Screening measures are far from adequate and not widely available in resourcepoor settings.Primary prevention strategies therefore remain necessary to reduce the risk of developing CRC.Increasing evidence from epidemiological studies,randomized clinical trials and basic science supports the effectiveness of aspirin,as well as other non-steroidal anti-inflammatory drugs,for chemoprevention of several types of cancer,including CRC.This includes the prevention of adenoma recurrence and reduction of CRC incidence and mortality.The detectable benefit of daily low-dose aspirin(at least 75 mg),as used to prevent cardiovascular disease events,strongly suggests that its antiplatelet action is central to explaining its antitumor efficacy.Daily low-dose aspirin achieves complete and persistent inhibition of cyclooxygenase(COX)-1 in platelets(in pre-systemic circulation)while causing alimited and rapidly reversible inhibitory effect on COX-2and/or COX-1 expressed in nucleated cells.Aspirin has a short half-life in human circulation(about 20 minutes);nucleated cells have the ability to resynthesize acetylated COX isozymes within a few hours,while platelets do not.COX-independent mechanisms of aspirin have been suggested to explain its chemopreventive effects but this concept remains to be demonstrated in vivo at clinical doses. | Carlos Sostres Carla Jerusalen Gargallo Angel Lanas | 2014 | World Journal of Gastrointestinal Pharmacology and Therapeutics2014，5，1： | 8 |
| 13 | Residual platelet reactivity is preferred over platelet inhibition rate in monitoring antiplatelet efficacy: insights using thrombelastography显示文摘Although thrombelastography(TEG)has been widely implemented in the clinical setting of endovascular intervention,consensus on the optimal parameter for defining high ischemic risk patients is lacking due to the limited data about the relationship between various TEG parameters and clinical outcomes.In this article,we report a post hoc analysis of a prospective,single-center cohort study,including 447 patients with acute coronary syndrome(ACS).Arachidonic acid(AA)-or adenosine diphosphate(ADP)-induced platelet-fibrin clot strength(MAAA or MAADP)was indicative of the net residual platelet reactivity after the treatment with aspirin or clopidogrel,respectively.AA%or ADP%was indices of the relative platelet inhibition rate on AA or ADP pathway.We found that each parameter alone was predictive of the risk of 6-month ischemic event,even after adjusting for confounding factors.However,the association between AA%and clinical outcome disappeared when further adjusted for MAAA.Likewise,inclusion of MAADP changed the significant relation between ADP%and clinical outcome.MAADP>47.0 mm and MAAA>15.1 mm were identified as the optimal cutoffs by receiver operating characteristic analysis.High MAAA(HR=3.963;95%CI:1.152–13.632;P=0.029)and high MAADP(HR=5.185;95%CI:2.228–12.062;P<0.001)were independent predictors when both were included in multivariable Cox regression hazards model.Interestingly,an even higher risk was found for the coexisting high MAAA and high MAADP(HR=7.870;95%CI:3.462–17.899;P<0.001).We conclude that when performing TEG to predict clinical efficacy,residual platelet reactivity has superiority over platelet inhibition rate as a measure of thrombotic risk in patients treated with aspirin and clopidogrel after ACS. | Hong-yi Wu Chi Zhang Xin Zhao Ju-ying Qian Qi-bing Wang Jun-bo Ge | 2020 | Acta Pharmacologica Sinica2020，41，2： | 8 |
| 14 | Increased susceptibility of aging gastric mucosa to injury and delayed healing:Clinical implications显示文摘In this editorial we comment on the article by Fukushi K et al published in the recent issue of the World Journal of Gastroenterology 2018; 24(34): 3908-3918. We focus specifically on the mechanisms of the anti-thrombotic action of aspirin, gastric mucosal injury and aging-related increased susceptibility of gastric mucosa to injury. Aspirin is widely used not only for the management of acute and chronic pain and arthritis, but also importantly for the primary and secondary prevention of cardiovascular events such as myocardial infarcts and strokes. Clinical trials have consistently shown that antiplatelet therapy with long term, low dose aspirin(LDA)-75 to 325 mg daily, dramatically reduces the risk of non-fatal myocardial infarcts, stroke and mortality in patients with established arterial diseases. However, such treatment considerably increases the risk of gastrointestinal(GI) ulcerations and serious bleeding by > 2-4 fold, especially in aging individuals. This risk is further increased in patients using LDA together with other antiplatelet agents, other nonsteroidal anti-inflammatory agents(NSAIDs) and/or alcohol, or in patients with Helicobacter pylori(H. pylori) infection. Previous studies by our group and others have demonstrated prominent structural and functional abnormalities in gastric mucosa of aging individuals(which we refer to as aging gastric mucosa or 'aging gastropathy') compared to the gastric mucosa of younger individuals. Aging gastric mucosa has impaired mucosal defense, increased susceptibility to injury by a variety of noxious agents such as aspirin, other NSAIDs and ethanol, and delayed and impaired healing of injury. The mechanism underlying these abnormalities of aging gastric mucosa include reduced mucosal blood flowcausing hypoxia, upregulation of PTEN, activation of proapoptotic caspase-3 and caspase-9, and reduced survivin(anti-apoptosis protein), importin-α(nuclear transport protein), vascular endothelial growth factor, and nerve growth factor. The decision regarding initiation of a long-term LDA therapy should be made after a careful consideration of both cardiovascular and GI risk factors. The latter include a previous history of GI bleeding and/or ulcers, age ≥ 70, male gender, concurrent use of other NSAIDs, alcohol consumption and H. pylori infection. Furthermore, the incidence of GI ulcers and bleeding can be reduced in patients on long term LDA treatment by several measures. Clinicians treating such patients should test for and eradicate H. pylori, instruct patients to avoid alcohol and non-aspirin NSAIDs, including cyclooxygenase-2-selective NSAIDs, and prescribe proton pump inhibitors in patients on LDA therapy. In the future, clinicians may be able to prescribe one of several potential new drugs, which include aspirin associated with phosphatidylcholine(PL2200), which retains all property of aspirin but reduces by approximately 50% LDA-induced GI ulcerations. | Andrzej S Tarnawski Amrita Ahluwalia | 2018 | World Journal of Gastroenterology2018，24，42： | 8 |
| 15 | 双重抗血小板聚集治疗缺血性脑卒中显示文摘抗血小板聚集是防治缺血性脑卒中的重要措施之一。但临床上某些患者对阿司匹林(aspirin)不能耐受或效果欠佳,以及血管内支架成形术的广泛应用,使得氯吡格雷与阿司匹林联合应用成为目前研究的热题。现结合临床多中心研究结果讨论联合抗血小板聚集治疗的机制、有效性及安全性。 | 左凤同 董爱勤 | 2016 | 脑与神经疾病杂志2016，24，1： | 8 |
| 16 | Aspirin inhibits the proliferation of hepatoma cells through controlling GLUT 1-mediated glucose metabolism显示文摘Aspirin can efficiently inhibit liver cancer growth,but the mechanism is poorly,understood.In this study,we-report that aspirin modulates glucose uptake through downregulating glucose transporter 1 (GLUT1),leading to the inhibition of hepatoma cell proliferation.Our data showed that aspirin significantly decreased the levels of reactive oxygen species (ROS)and glucose consumption in hepatoma cells.Interestingly,we identified that GLUT1 and HIF1α could be decreased by aspirin.Mechanically,we demonstrated that the -1008/-780 region was the regulatory element of transcriptional factor NF-κB in GLUT1 promoter by luciferase report gene assays.PDTC,an inhibitor of NF-KB,could suppress the expression of GLUT1 in HepG2 and H7402 cells,: followed by affecting the levels of ROS and glucose consumption.CoCl2-activated HIF1α expression could slightly rescue the GLUT1 expression inhibited by aspirin or PDTC,suggesting that aspirin depressed GLUT1 through targeting NF-κB or NF-κB/HIFla signaling.Moreover,we found that GLUT1 was highly expressed in clinical HCC tissues relating to their paired adjacent normal tissues.Importantly,we observed that high level of GLUT1 was significantly correlated with the poor relapse-free survival of HCC patients by analysis of public data.Functionally,overexpression of GLUT1 blocked the PDTC-induced or aspirin-induced inhibition of glucose metabolism in HepG2 cells.Conversely,aspirin failed to work when GLUT1 was stably knocked down in the cells. Administration of aspirin could depress the growth of hepatoma cells through controlling GLUT1 in vitro and in vivo.Thus,our finding provides new insights into the mechanism by which aspirin depresses liver cancer. | Yun-xia Liu Jin-yan Feng Ming-ming Sun Bo-wen Liu Guang Yang Ya-nan Bu Man Zhao Tian-jiao Wang Wei-ying Zhang Hong-feng Yuan Xiao-dong Zhang | 2019 | Acta Pharmacologica Sinica2019，40，1： | 8 |
| 17 | LC-MS/MS法定量测定人血浆中阿司匹林及其代谢产物水杨酸显示文摘A sensitive liquid chromatography-electrospray ionization-tandem mass spectrometric (LC-MS/MS) method for the simultaneous determination of aspirin (ASA) and its metabolite salicylic acid (SA) in human plasma has been developed and validated.The plasma ASA and SA were extracted using a liquid-liquid extraction (LLE) and the sample extract was injected onto the LC-MS/MS system.The limits of quantitation(LLOQ) for ASA and SA are both 25 ng/mL.This method allowed the reproducible and accurate quantification with the concentration rang of 25-10 000 ng/mL.This method could be applied to the quantitation aspirin and salicylic acid in human plasma. | 彭翱 周辉 江骥 胡蓓 | 2007 | 分析测试学报2007，26，z1： | 7 |
| 18 | Aspirin resistance: Fact or fiction? A point of view显示文摘Aspirin is a wonder drug that has been used for well over 100 years for its analgesic and antipyretic effects. For the past three decades, it has increasingly been used for the prevention of primary and secondary cardiovascular events. Lately, it has been suggested that a significant number of individuals taking aspirin have become resistant to this drug. The phenomenon of 'aspirin resistance' is based on the observation of clinical events in some patients taking aspirin, and/or a diminished platelet aggregation inhibitory response to aspirin therapy. Unfortunately, laboratory assays used to monitor the efficacy of aspirin are far from accurate and the results are not reproducible. Furthermore, results of different platelet function tests are often not congruent. In addition, platelet aggregation studies show marked interindividual and intra-individual variability. Patients with coronary heart disease take many drugs that interfere with the effect of aspirin on platelet aggregation. Besides inhibiting formation of thromboxane A2 from arachidonic acid, aspirin has a host of platelet-independent effects that complement its platelet inhibitory effects. Laboratory assays designed to measure platelet function do not take into account these pleiotropic effects of aspirin. In our view, use of the term 'aspirin resistance' based on inadequate knowledge of imperfect laboratory tests does a disservice to physicians and patients. | Jawahar L Mehta Bhavna Mohandas | 2010 | World Journal of Cardiology2010，2，9： | 7 |
| 19 | Effects and safety of aspirin use in patients after cerebrovascular bypass procedures显示文摘Object Superficial temporal artery to middle cerebral artery(STA-MCA)bypass is the most effective treatment for Moyamoya disease(MMD).In this study,we aimed to assess whether aspirin improves STA-MCA bypass patency and is safe in patients with MMD.Methods We performed a retrospective medical record review of patients with ischaemic-onset MMD who had undergone STA-MCA bypass at two hospitals between January 2011 and August 2018,to clarify the effects and safety of aspirin following STA-MCA bypass.The neurological status at the last follow-up(FU)was compared between patients with FU bypass patency and occlusion.Results Among 217 identified patients(238 hemispheres),the mean age was 41.4±10.2 years,and 51.8%were male;the indications for STA-MCA bypass were stroke(48.2%),followed by a transient ischaemic attack(44.0%).Immediate bypass patency was confirmed in all cases.During the FU period(1.5±1.5 y),15 cases were occluded at FU imaging,resulting in an overall cumulative patency rate of 94%.The patency rates were 93%and 94%in the short-term FU group(n=131,mean FU time 0.5±0.2 years)and long-term FU group(n=107,mean FU time 4.1±3.5 years),respectively.The STA-MCA bypass patency rate in the aspirin group was higher than that in the non-aspirin group(98.7%vs 89.7%;HR 1.57;95%CI 1.106 to 2.235;p=0.012).No significant difference in the FU haemorrhagic events was observed between the aspirin and non-aspirin groups.Conclusions Among adult patients with ischaemic-onset MMD undergoing STA-MCA bypass procedures,aspirin might increase the bypass patency rate,without increasing the bleeding risk.FU bypass patency may be associated with a better outcome.Additional studies,especially carefully designed prospective studies,are needed to address the role of aspirin after bypass procedures. | Junlin Lu Guangchao Shi Yuanli Zhao Rong Wang Dong Zhang Xiaolin Chen Hao Wang Ji Zong Zhao | 2021 | Stroke & Vascular Neurology2021，6，4： | 7 |
| 20 | Small bowel ulcerative lesions are common in elderly NSAIDs users with peptic ulcer bleeding显示文摘AIM: To determine the frequency of small bowel ulcerative lesions in patients with peptic ulcer and define the significance of those lesions. METHODS: In our prospective study, 60 consecutive elderly patients with upper gastrointestinal bleeding from a peptic ulceration(cases) and 60 matched patients with a non-bleeding peptic ulcer(controls) underwent small bowel capsule endoscopy, after a negative colonoscopy(compulsory in our institution). Controls were evaluated for non-bleeding indications. Known or suspected chronic inflammatory conditions and medication that could harm the gut were excluded. During capsule endoscopy, small bowel ulcerative lesions were counted thoroughly and classified according to Graham classification. Other small bowellesions were also recorded. Peptic ulcer bleeding was controlled endoscopically, when adequate, proton pump inhibitors were started in both cases and controls, and Helicobacter pylori eradicated whenever present. Both cases and controls were followed up for a year. In case of bleeding recurrence upper gastrointestinal endoscopy was repeated and whenever it remained unexplained it was followed by repeat colonoscopy and capsule endoscopy.RESULTS: Forty(67%) cases and 18(30%) controls presented small bowel erosions(P = 0.0001), while 22(37%) cases and 4(8%) controls presented small bowel ulcers(P < 0.0001). Among non-steroidal antiinflammatory drug(NSAID) consumers, 39(95%) cases and 17(33%) controls presented small bowel erosions(P < 0.0001), while 22(55%) cases and 4(10%) controls presented small bowel ulcers(P < 0.0001). Small bowel ulcerative lesions were infrequent among patients not consuming NSAIDs. Mean entry hemoglobin was 9.3(SD = 1.4) g/d L in cases with small bowel ulcerative lesions and 10.5(SD = 1.3) g/dL in those without(P = 0.002). Cases with small bowel ulcers necessitate more units of packed red blood cells. During their hospitalization, 6(27%) cases with small bowel ulcers presented bleeding recurrence most possibly attributed to small bowel ulcers, nevertheless 30-d mortality was zero. Presence of chronic obstructive lung disease and diabetes was related with unexplained recurrence of hemorrhage in logistic regression analysis, while absence of small bowel ulcers was protective(relative risk 0.13, P = 0.05).CONCLUSION: Among NSAID consumers, more bleeders than non-bleeders with peptic ulcers present small bowel ulcers; lesions related to more severe bleeding and unexplained episodes of bleeding recurrence. | Panagiotis Tsibouris Chissostomos Kalantzis Periklis Apostolopoulos Antonios Zalonis Peter Edward Thomas Isaacs Mark Hendrickse Georgios Alexandrakis | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，12： | 6 |
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