rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2006-2-3-46-50rpcardio-1032Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯCLINICAL SIGNIFICANCE OF ASPIRIN RESISTANCE IN PATIENTS WITH CARDIO-VASCULAR DISEASESКЛИНИЧЕСКАЯ ЗНАЧИМОСТЬ РЕЗИСТЕНТНОСТИ К АСПИРИНУ У ПАЦИЕНТОВ С СЕРДЕЧНО-СОСУДИСТЫМИ ЗАБОЛЕВАНИЯМИДовгалевскийП. Я.DovgalevskyP. J.ФурманН. В.FurmanN. V.ПучиньянН. Ф.PuchinianN. F.Саратовский научно-исследовательский институт кардиологии РосздраваРоссияSaratov Research Center of Cardiology, RoszdravRussian Federation200624012016234650Copyright © Dovgalevsky P.J., Furman N.V., Puchinian N.F., 20162016Довгалевский П.Я., Фурман Н.В., Пучиньян Н.Ф.Dovgalevsky P.J., Furman N.V., Puchinian N.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/1032

Atherothrombosis is a complication of ischemic heart disease, and it leads to development of acute coronary syndrome. Atherothrombosis is characterized by sudden destruction of atherosclerotic plaque, which results into platelets activation and thrombus formation. Aspirin - one of the most widely used antiaggregate drugs, prevents development of the recurring myocardium infarction, stroke, sudden coronary death. But in number of patients aspirin is not efficient. Development of repeated thrombotic complications with aspirin therapy or resistance to aspirin is independent predictor of high coronary risk. There are controversial data about aspirin resistance incidence, which varies from 5 to 48%. Possible reasons for this are discussed: low compliance with treatment, peculiarities of functional condition of platelets, genetically given variability of platelet receptors etc. Different methods, based on estimation of platelets activity are proposed to assess the possibility of repeated thrombotic complications, caused by resistance to aspirin. Further researches including valid number of patients are needed to assess incidence of aspirin resistance and to reveal mechanisms of its development.

Осложнением ишемической болезни сердца является атеротромбоз, приводящий к развитию острого коронарного синдрома. Атеротромбоз характеризуется внезапным повреждением атеросклеротической бляшки, ведущим к активации тромбоцитов и образованию тромба.  Аспирин - один из наиболее широко используемых антиагрегантных препаратов, предупреждает развитие повторного инфаркта миокарда, инсульта, внезапной коронарной смерти. Но у ряда больных аспирин оказывается неэффективным. Развитие повторных тромботических осложнений на фоне терапии аспирином или резистентность к аспирину является независимым предиктором высокого коронарного риска. Имеются разноречивые данные о распространенности резистентности к аспирину, которая колеблется от 5 до 48%. Обсуждается ряд возможных причин этого явления: низкая приверженность лечению, особенности функционального состояния тромбоцитов, генетически обусловленная изменчивость рецепторов тромбоцитов и др. Для оценки вероятности повторных тромботических осложнений, обусловленных резистентностью к аспирину, предложены различные методы, основанные на определении функциональной активности тромбоцитов. Требуется продолжение исследований, включающих достаточное количество больных, для оценки распространенности резистентности к аспирину, выявления механизмов, лежащих в основе ее развития.

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The authors declare that there are no conflicts of interest present.