Cardiology: Aspirin Resistance in Patients with Stable Coronary Artery Disease with and without a History of Myocardial Infarction

@article{Dorsch2007CardiologyAR,
  title={Cardiology: Aspirin Resistance in Patients with Stable Coronary Artery Disease with and without a History of Myocardial Infarction},
  author={Michael P. Dorsch and Jin Sun Lee and Donald R. Lynch and Steven P. Dunn and Jo Ellen Rodgers and Todd A. Schwartz and Emily Colby and Deborah Montague and Susan S. Smyth},
  journal={Annals of Pharmacotherapy},
  year={2007},
  volume={41},
  pages={737 - 741}
}
Background: Aspirin therapy is a cornerstone in the prevention of atherothrombotic events, but recurrent vascular events are estimated to occur in 8-18% of patients taking aspirin for secondary prevention after 2 years. Estimates of biologic aspirin resistance vary from 5% to 60%, depending on the assay used. However, the relationship between biologic measurements of aspirin resistance and adverse clinical events remains unclear. Objective: To determine whether patients with documented… 

Figures and Tables from this paper

Comparison of laboratory detection methods of aspirin resistance in coronary artery disease patients
TLDR
Although the correlation between the aggregometry and VerifyNow was low, with defined criteria both methods gave 91.9% agreement to find AR, VerifyNow showed a higher sensitivity to detect AR and further studies are required to biologically define AR and to alter therapy based on platelet function tests.
Aspirin Resistance: Disparities and Clinical Implications
TLDR
Clinical trial data from studies observing resistance have revealed that regardless of study size, dose of aspirin, control for drug interactions and adherence, or assay used to measure platelet function, aspirin resistance is associated with an increased risk for adverse events.
The Role of Aspirin in Cardiovascular Disease Prevention in Women
TLDR
Despite the evidence base and guidelines, the use of aspirin in women remains suboptimal and warrants improved provider and patient awareness.
Aspirin and antiplatelet agent resistance: implications for prevention of secondary stroke.
TLDR
The concept of antiplatelet resistance in general is discussed, focusing on aspirin resistance in particular, as a poorly defined cause of recurrent vascular events, and alternatives for the secondary stroke patient must be explored.
Aspirin resistance in patients with chronic renal failure.
TLDR
Patients with CRF have higher frequency of aspirin resistance, which might further increase the risk of cardiovascular morbidity and mortality in these patients.
Increased platelet aggregation and serum thromboxane levels in aspirin-treated patients with prior myocardial infarction.
TLDR
Serum thromboxane B2 levels were higher in MI patients than in patients without prior MI, and patients on aspirin before MI onset had higher aggregation levels compared with patients not on aspirin.
Aspirin and Antiplatelet Agent Resistance
TLDR
The concept of antiplatelet resistance in general is discussed, focusing on aspirin resistance in particular, as a poorly defined cause of recurrent vascular events, and alternatives for the secondary stroke patient must be explored.
Predictors of successful acetylsalicylic acid resistance suppression after percutaneous coronary revascularisation.
TLDR
ASA resistance overcoming by dose doubling can be achieved more often in males and in subjects with lower ARU value at ASA 75 mg, although the threshold value at which ARU at 75 mg ASA treatment was predictive of successful ASA resistance overcoming was ≤ 608 ARU.
...
...

References

SHOWING 1-10 OF 20 REFERENCES
Assessing aspirin responsiveness in subjects with multiple risk factors for vascular disease with a rapid platelet function analyzer
TLDR
The Ultegra RPFA-ASA analyzer is a novel, fast method that could be used in clinical practice for monitoring efficacy of aspirin, and for triaging the aspirin-resistant population.
Aspirin resistance and atherothrombotic disease.
Development of Aspirin Resistance in Persons With Previous Ischemic Stroke
TLDR
The antiplatelet effect of a fixed dose of ASA is not constant over time in all individuals, and the mechanisms by which increased dosage requirement or ASA resistance develops and the clinical significance of this development are currently undefined.
Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials.
TLDR
For women and men, aspirin therapy reduced the risk of a composite of cardiovascular events due to its effect on reducing therisk of ischemic stroke in women and MI in men.
Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients
TLDR
Aspirin (or another oral antiplatelet drug) is protective in most types of patient at increased risk of occlusive vascular events, including those with an acute myocardial infarction or ischaemic stroke, unstable or stable angina, previous myocardian infarctions, stroke or cerebral ischaemia, peripheral arterial disease, or atrial fibrillation.
Aspirin Resistance: An Evaluation of Current Evidence and Measurement Methods
TLDR
Evidence indicates that aspirin resistance is a dynamic state, with significant intrapatient variability in aspirin sensitivity with time, and strategies to identify and treat patients resistant to aspirin are needed.
Influence of gender and age on preventing cardiovascular disease by antihypertensive treatment and acetylsalicylic acid. The HOT study. Hypertension Optimal Treatment.
TLDR
Lowering of diastolic BP to about 80 mmHg in hypertensive women and, in addition, the administration of 75 mg of ASA to well-treated hypertensive men appear to effectively reduce the most common cardiovascular complication, i.e. myocardial infarction, in patients with essential hypertension.
Influence of gender and age on preventing cardiovascular disease by antihypertensive treatment and acetylsalicylic acid. The HOT study
TLDR
Lowering of diastolic BP to about 80 mmHg in hypertensive women and, in addition, the administration of 75 mg of ASA to well-treated hypertensive men appear to effectively reduce the most common cardiovascular complication, i.e. myocardial infarction, in patients with essential hypertension.
Female-specific aspects in the pharmacotherapy of chronic cardiovascular diseases.
TLDR
This review treats the most important pharmacodynamic gender-relevant differences in this context, and surveys available evidence on the benefits of therapy of chronic cardiovascular diseases in women.
...
...