Prevalence of aspirin resistance and related factors in patients with type-2 diabetes mellitus

Lim, Yun Hyek; Park, Byoung Hyun; Cho, Chung Gu

Abstract

BACKGROUND/AIMS: The risk of cardiovascular morbidity and mortality is high in patients with diabetes. Since studies suggest that aspirin is less effective in diabetic patients, this study evaluated the prevalence of aspirin resistance and related factors in Korean type-2 diabetics.
METHODS
All patients taking aspirin 100 mg/day for at least 4 weeks and no other anti-platelet agents were enrolled. The compliance of aspirin intake was determined from patient interviews and using the pill-count method. All other medications were continued during the study, including oral hypoglycemics, antihypertensives, and lipid-lowering agents. The effect of aspirin was assessed using the Ultegra Rapid Platelet Function Assay-ASA (VerifyNow-Aspirin, Accumetrics, San Diego, CA) and aspirin resistance was defined as >550 aspirin reaction units (ARU).
RESULTS
The prevalence of aspirin resistance in Korean type-2 diabetics was 14.8%, and was more prevalent in males than in females (28.1% vs. 7.1%). Aspirin resistance was correlated with male sex, smoking, high hemoglobin levels, a high estimated glomerular filtration rate (GFR), and low fibrinogen levels. After controlling for sex, aspirin resistance was related to the estimated GFR (r=0.247, p=0.029), hemoglobin (r=0.23, p=0.043), and fibrinogen (r=0.304, p=0.007) levels.
CONCLUSION
The prevalence of aspirin resistance in Korean type-2 diabetics was 14.8%. Therefore, a laboratory test for aspirin resistance should be considered in diabetic patients taking aspirin to prevent cardiovascular complications.