Clinical relevance of aspirin resistance in patients with stable coronary artery disease: a prospective follow-up study (PROSPECTAR)
BLOOD COAGULATION & FIBRINOLYSIS, vol.18, no.2, pp.187-192, 2007 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 18 Issue: 2
- Publication Date: 2007
- Doi Number: 10.1097/mbc.0b013e328040c115
- Journal Name: BLOOD COAGULATION & FIBRINOLYSIS
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Page Numbers: pp.187-192
- Keywords: aspirin resistance, atherothrombosis, clinical outcome, major adverse cardiovascular events, stable coronary artery disease, LOW-DOSE ASPIRIN, THROMBOXANE BIOSYNTHESIS, PLATELET INHIBITION, IIIA POLYMORPHISM, IN-VITRO, RISK, NONRESPONSIVENESS, NONRESPONDER, PREVALENCE, ASA
- Acibadem Mehmet Ali Aydinlar University Affiliated: No
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 (115.4%) with aspirin resistance and in 20 patients (111.0%) 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.