Abstract

The main objective of this study is to evaluate the effect of Xuefu Zhuyu decoction on aspirin resistance in acute coronary syndrome patients. We enrolled 45 patients with aspirin resistance and divided them randomly into control group (group A) and treatment group (group B). We applied Xuefu Zhuyu decoction to the group B for 4 w. Before treatment and after 4 w of treatment, we evaluated the platelet reactivity, and performed biochemical and molecular biology analyses from both subgroups. Through logistic regression analysis, we assessed the association between improvement of platelet function and confounding factors. Lastly, clinical follow-ups for 1 mo and 12 mo were performed to analysis the therapeutic effects. We found the aspirin reaction unit was clearly on decline 602.35±26.49 vs. 542.48±43.09 (before treatment vs. after treatment; p<0.001) in group B. Through quantitative reverse transcription-polymerase chain reaction and radioimmunoassay, we assessed the expression of cyclooxygenase-1 and thromboxane A2, and the results indicated that after treatment, the thromboxane A2 decreased 503.4±12.0 vs. 447.8±48.5 (before treatment vs. after treatment; p<0.001). In group B, hemorheology improved significantly, and plasma viscosity, whole blood viscosity along with fibrinogen decreased significantly (all p<0.01). Meanwhile, in group B, the glucose was correlated with aspirin reaction unit and the expression of thromboxane A2 was a protective factor of aspirin reaction unit, and aspirin resistance patients would suffer less major adverse cardiac events (p=0.024). Xuefu Zhuyu decoction might reduce hyporesponsiveness of aspirin by inhibiting thromboxane A2 and improve the hemorheological index, which are of great significance for the prevention in cardiovascular events.