Clinical relevance of aspirin resistance in patients with stable coronary artery disease: a prospective follow-up study (PROSPECTAR) - PubMed (original) (raw)
Clinical Trial
Clinical relevance of aspirin resistance in patients with stable coronary artery disease: a prospective follow-up study (PROSPECTAR)
Burak Pamukcu et al. Blood Coagul Fibrinolysis. 2007 Mar.
Abstract
Aspirin resistance may increase the risk of major adverse cardiac events (MACE) more than threefold in patients with stable coronary artery disease (CAD). This study aimed to determine the prevalence of aspirin resistance in patients with stable CAD, the role of aspirin resistance on outcome in the follow-up, and the effect of clopidogrel therapy in MACE prevention in aspirin-resistant individuals. We detected the prevalence of aspirin resistance in 234 patients with stable CAD. Platelet function was determined by PFA-100 with collagen and/or epinephrine and collagen and/or ADP cartridges. The mean follow-up time was 20.6 +/- 6.9 months. The primary endpoints of the study were occurrence of myocardial infarction, unstable angina, stroke and cardiac death. Of patients, 22.2% (n = 52) were aspirin resistant by PFA-100. During follow-up, MACE occurred in eight patients (15.4%) with aspirin resistance and in 20 patients (11.0%) with aspirin-sensitive platelet aggregation (P = 0.269). MACE increased in aspirin-resistant patients after termination of clopidogrel therapy. Eleven patients experienced MACE after cessation of clopidogrel therapy (P < 0.001). The MACE risk in patients with stable CAD having detected aspirin resistance was similar compared with patients having aspirin-sensitive platelet aggregation by PFA-100. The MACE prevalence increased during follow-up, however, just after cessation of clopidogrel therapy.
Similar articles
- Major clinical vascular events and aspirin-resistance status as determined by the PFA-100 method among patients with stable coronary artery disease: a prospective study.
Christiaens L, Ragot S, Mergy J, Allal J, Macchi L. Christiaens L, et al. Blood Coagul Fibrinolysis. 2008 Apr;19(3):235-9. doi: 10.1097/MBC.0b013e3282f9ade8. Blood Coagul Fibrinolysis. 2008. PMID: 18388505 Clinical Trial. - Impact of platelet reactivity on cardiovascular outcomes in patients with type 2 diabetes mellitus and coronary artery disease.
Angiolillo DJ, Bernardo E, Sabaté M, Jimenez-Quevedo P, Costa MA, Palazuelos J, Hernández-Antolin R, Moreno R, Escaned J, Alfonso F, Bañuelos C, Guzman LA, Bass TA, Macaya C, Fernandez-Ortiz A. Angiolillo DJ, et al. J Am Coll Cardiol. 2007 Oct 16;50(16):1541-7. doi: 10.1016/j.jacc.2007.05.049. Epub 2007 Oct 1. J Am Coll Cardiol. 2007. PMID: 17936152 - Aspirin-resistant platelet aggregation in a cohort of patients with coronary heart disease.
Pamukcu B, Oflaz H, Onur I, Oncul A, Umman B, Koylan N, Bugra Z, Meric M, Nisanci Y. Pamukcu B, et al. Blood Coagul Fibrinolysis. 2007 Jul;18(5):461-5. doi: 10.1097/MBC.0b013e32814db7e7. Blood Coagul Fibrinolysis. 2007. PMID: 17581321 - Indications for dual antiplatelet therapy with aspirin and clopidogrel: evidence-based recommendations for use.
Reaume KT, Regal RE, Dorsch MP. Reaume KT, et al. Ann Pharmacother. 2008 Apr;42(4):550-7. doi: 10.1345/aph.1K433. Epub 2008 Mar 4. Ann Pharmacother. 2008. PMID: 18319394 Review. - Variability in platelet response to the antiplatelet agents aspirin and clopidogrel: mechanisms, measurement, and clinical relevance.
Jennings LK. Jennings LK. Crit Pathw Cardiol. 2009 Mar;8(1):20-8. doi: 10.1097/HPC.0b013e318194e45e. Crit Pathw Cardiol. 2009. PMID: 19258834 Review.
Cited by
- Aspirin treatment failure: is this a real phenomenon? A review of the aetiology and how to treat it.
Shahid F, Chahal CA, Akhtar MJ. Shahid F, et al. JRSM Short Rep. 2013 Apr;4(4):30. doi: 10.1177/2042533313475576. Epub 2013 Mar 27. JRSM Short Rep. 2013. PMID: 23560230 Free PMC article. - Clinical importance of aspirin and clopidogrel resistance.
Feher G, Feher A, Pusch G, Koltai K, Tibold A, Gasztonyi B, Papp E, Szapary L, Kesmarky G, Toth K. Feher G, et al. World J Cardiol. 2010 Jul 26;2(7):171-86. doi: 10.4330/wjc.v2.i7.171. World J Cardiol. 2010. PMID: 21160749 Free PMC article. - vWF/ADAMTS13 is associated with on-aspirin residual platelet reactivity and clinical outcome in patients with stable coronary artery disease.
Warlo EMK, Pettersen AR, Arnesen H, Seljeflot I. Warlo EMK, et al. Thromb J. 2017 Nov 22;15:28. doi: 10.1186/s12959-017-0151-3. eCollection 2017. Thromb J. 2017. PMID: 29200971 Free PMC article. - Aspirin resistance.
Mansour K, Taher AT, Musallam KM, Alam S. Mansour K, et al. Adv Hematol. 2009;2009:937352. doi: 10.1155/2009/937352. Epub 2009 Apr 14. Adv Hematol. 2009. PMID: 19960045 Free PMC article. - Preoperative aspirin resistance does not increase myocardial injury during off-pump coronary artery bypass surgery.
Kim HJ, Lee JM, Seo JH, Kim JH, Hong DM, Bahk JH, Kim KB, Jeon Y. Kim HJ, et al. J Korean Med Sci. 2011 Aug;26(8):1041-6. doi: 10.3346/jkms.2011.26.8.1041. Epub 2011 Jul 27. J Korean Med Sci. 2011. PMID: 21860554 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous