Acetylsalicylic acid resistance risk factors in patients with myocardial infarction

Implementation of recommendations on the check of risk factors for cardiovascular diseases in patients undergoing coronary re-interventions

METHOD

The study involved 905 patients after coronary interventions, qualified for invasive diagnosis due to symptomatic coronary disease.

AIM

The aim of this study was to check the implementation of recommendations on the control of risk factors for cardiovascular diseases in patients undergoing re-interventions.

RESULTS

Compared to elderly persons, younger people more often increased their physical activity (62 vs. 65 years, p = 0.009), stopped smoking (61 vs. 65 years, p < 0.001) and reduced alcohol consumption (62 vs. 65 years, p = 0.001). People with secondary and higher education increased their physical activity more often than those with primary education (51%, 31% vs. 23%, p = 0.006). Men more often than women decided to limit their alcohol consumption (48% vs. 37%, p = 0.007). Patients with a history of acute coronary syndrome were more likely to quit smoking and reduce their alcohol consumption than those without such a history (47% vs. 37%, p = 0.003 and 42% vs. 34%, p = 0.020, respectively). Only 2% of the subjects achieved the recommended LDL cholesterol values. Forty-eight percent were qualified for reinvasive procedures on the coronary arteries. Less than half of the patients undertook health-promoting behaviors that required modification of existing habits.

CONCLUSION

Age, gender, and education level influence pro-health behaviors. The majority of patients do not achieve the levels of LDL cholesterol and triglycerides consistent with the ESC guidelines in the secondary prevention of coronary disease. Inadequate check of risk factors may result in faster disease progression and coronary re-interventions.

Ketoprofen and aspirin removal by laccase immobilized on date stones

In recent years, enzymatic remediation/biocatalysis has gained prominence for the bioremediation of recalcitrant chemicals. Laccase is one of the commonly investigated enzymes for bioremediation applications. There is a growing interest in immobilizing this enzyme onto adsorbents for achieving high pollutant removal through simultaneous adsorption and biodegradation. Due to the influence of the biomolecule-support interface on laccase activity and stability, it is crucial to functionalize the solid carrier prior to immobilization. Date stone (PDS), as an eco-friendly, low-cost, and effective natural adsorbent, was utilized as a carrier for laccase (fungus Trametes versicolor). After activating PDS through chemical treatments, the surface area increased by thirty-six-fold, and carbonyl groups became more prominent. Batch experiments were carried out for ketoprofen and aspirin biodegradation in aqueous solutions. After six cycles, the laccase maintained 54% of its original activity confirmed by oxidation tests of 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS). In addition, the storage, pH, and thermal stability of immobilized laccase on functionalized date stone (LFPDS) were found to be superior to that of free laccase, demonstrating its potential for ongoing applications. In the aqueous batch mode, this immobilized laccase system was used to degrade 25 mg L-1 of ketoprofen and aspirin, resulting in almost complete removal within 4 h of treatment. This study reveals that agricultural wastes such as date stone can successfully be valorized through simple activation techniques, and the final product can be used as an adsorbent and substrate for immobilization enzyme. The high efficiency of the LFPDS in removing ketoprofen and aspirin highlights the potential of this technology for removing pharmaceuticals and merits its continued development.

Acetylsalicylic Acid-Primus Inter Pares in Pharmacology

Acetylsalicylic acid (ASA) is one of the first drugs to be obtained by synthesis while being the most used. It has experienced the longest lasting commercial success and is considered the most popular drug of the modern era. ASA, originally used as an anti-inflammatory medication, nowadays is predominantly used as an antiplatelet agent for prophylaxis in cardiac patients. Many studies show that the benefits of using ASA far outweigh the potential risk of side effects. With particular emphasis on the possibility of ASA repositioning for new therapies, extending the indications for use beyond the diseases from the spectrum of atherosclerotic diseases, such as cancer, requires shifting the benefit-risk ratio, although very good, even more towards safety. Interesting activities consisting not only of changing the formulation but also modifying the drug molecule seem to be an important goal of the 21st century. ASA has become a milestone in two important fields: pharmacy and medicine. For a pharmacist, ASA is a long-used drug for which individual indications are practically maintained. For a doctor, acetylsalicylic acid is primarily an antiplatelet drug that saves millions of lives of patients with coronary heart disease or after a stroke. These facts do not exempt us from improving therapeutic methods based on ASA, the main goal of which is to reduce the risk of side effects, as well as to extend effectiveness. Modified acetylsalicylic acid molecules already seem to be a promising therapeutic option.

rs5911 and rs3842788 Genetic Polymorphism, Blood Stasis Syndrome, and Plasma TXB2 and hs-CRP Levels Are Associated with Aspirin Resistance in Chinese Chronic Stable Angina Patients

The identification of single nucleotide polymorphisms (SNPs) related to aspirin resistance (AR) is of great significance for the explanation why some individuals demonstrate an incomplete response to aspirin and for optimizing the antiplatelet therapy strategy. The study was designed to investigate the possible associated genetic markers and clinical factors of AR for Chinese patients with chronic stable angina after PCI and to analyze the association between TXA2, PGI2, hs-CRP level, AR, and gene polymorphisms. Totally 207 chronic stable angina patients who received 100 mg maintenance dose daily of aspirin for more than 7 days were enrolled. The inhibition of platelets was assessed using light transmittance aggregometry. TXB2, 6-keto-PGF1α, and hs-CRP were measured by radioimmunoassay. Genotyping was performed using Taqman probe technique (rs5787 and rs5911) and gene sequencing technology (rs3842788). By using binary logistic regression analysis, the impact of clinical and genetic determinants on AR was evaluated. The prevalence of AR and aspirin semiresistance (ASR) was 3.86% and 20.76%, respectively, in Chinese chronic stable angina patients. rs5911 A/C and C/C versus A/A genotype (OR = 5.546, 95% CI = 1.812–11.404), rs3842788 A/G versus G/G genotype (OR = 8.358, 95% CI = 2.470–28.286), and blood stasis syndrome (BSS, OR = 10.220, 95% CI = 4.242–24.621) were associated with AR, but rs5787 variants were all homozygous of G/G genotype. Plasma TXB2 and hs-CRP increased significantly in AR and ASR group, while 6-keto-PGF1α showed no difference, and TXB2 level was significantly higher in carriers of the rs3842788 A/G genotype. According to our results, rs5911 and rs3842788 are proved to be specific genetic markers of AR in Chinese chronic stable angina patients for the first time, and BSS was also proved to be a remarkable determinant for AR. The AR and ASR patients were with increased plasma TXB2 and hs-CRP levels, and the TXB2 level was influenced by the variation of rs3842788 genotype.