Тромбоз, гемостаз и реология

Tromboz, Gemostaz I Reologiya
scientific and practical journal

ISSN 2078–1008 (Print); ISSN 2687-1483 (online)
2021, Original papers
2021

Genetic aspects of aspirin resistance in patients with cerebrovascular pathology: 615.036.8

Original papers
Published 2021-10-04
Anastasia Kornilova
Research Center of Neurology; 80 Volokolamskoe Shosse, 125367 Moscow, Russia
ФГБУН «Научный центр неврологии»; Россия, 125367 Москва, Волоколамское шоссе, 80
Marine Tanashyan
Research Center of Neurology; 80 Volokolamskoe Shosse, 125367 Moscow, Russia
ФГБУН «Научный центр неврологии»; Россия, 125367 Москва, Волоколамское шоссе, 80
Anton Raskurazhev
Research Center of Neurology; 80 Volokolamskoe Shosse, 125367 Moscow, Russia
ФГБУН «Научный центр неврологии»; Россия, 125367 Москва, Волоколамское шоссе, 80
Alla Shabalina
Research Center of Neurology; 80 Volokolamskoe Shosse, 125367 Moscow, Russia
ФГБУН «Научный центр неврологии»; Россия, 125367 Москва, Волоколамское шоссе, 80
Eugene Roitman
Research Center of Neurology; 80 Volokolamskoe Shosse, 125367 Moscow, Russia; Pirogov Russian National Research Medical University, Health Ministry of Russian Federation; 1 Ostrovityanova Str., Moscow 117997, Russia
ФГБУН «Научный центр неврологии»; Россия, 125367 Москва, Волоколамское шоссе, 80; ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Министерства здравоохранения Российской Федерации; Россия, 117997 Москва, ул. Островитянова, 1

Keywords

cerebrovascular disease
aspirin resistance
genetic polymorphisms of the type 1 cyclooxygenase gene
acetylsalicylic acid
  Full Text

Abstract

Summary. Background. Cerebrovascular disease (CVD) and stroke remain one of the leading causes of death worldwide. The genetic component of stroke has been proven; genetic polymorphisms can alter the response to pharmacological agents. Acetylsalicylic acid (ASA) is the “gold standard” for antiplatelet treatment of CVD. Since the beginning of the XXI century, the world science has accumulated facts about the insufficient effect of ASA, so the term aspirin resistance appeared. Objectives: to assess hemorhe‐ ological and genetic factors to the occurrence of the phenomenon of aspirin resistance in patients with CVD. Patients/Methods. This prospective randomized controlled observational study included 186 patients with CVD, aged 45–75 years. All patients received 75 mg ASA daily. Clinical examination, assessment of cognitive status and compliance to treatment, a laboratory assessment of platelet function, a detailed biochemical blood test, identification of A842G polymorphisms of type 1 cyclooxygenase (COX‐1) gene (rs 10306114), C50T COX‐1 (rs3842787) and A1676G COX‐1 (rs3842787) and A1676G COX‐1 (rs1330344) were performed. Statistics was carried out using the IBM SPSS Statistics software. Results. The positive correlation was found between platelet aggregation (РА) with adenosine diphosphate (РА‐ADP) and adrenaline (РА‐Аdr) and an in vitro test with ASA (r = 0.722 and r = 0.689; p < 0.001). A nega‐ tive correlation was found between РА‐ADP and the Montreal Cognitive Assessment (MoCA) score for compliance to treatment (r=–0,845; p=0,001). Based on the analysis of PA, all examined patients were divided into ASA‐insensitive (group 1, n=100) and ASA‐sensitive (group 2, n=86). In the ASA‐insensitive group, there were more patients carrying at least one G allele of the COX‐1 gene rs1330344 polymorphism compared with patients in the ACK‐sensitive group (60.4% versus 47.7%; p<0.01). The presence of rs1330344 is often associated with type 2 diabetes mellitus (OR=3.749; 95% СI=1.937–7.254; p=0.001). C50T polymorphism of COX‐1 (rs3842787) according to logistic regression is associated with AT‐Adr (r=0.845; p<0.001). Conclusions. Genetic aspects should be considered among the causes of aspirin resistance in patients with CVD.

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