Aspirin Resistance

Mansour, Khaled; Taher, Ali T.; Musallam, Khaled M.; Alam, Samir

doi:10.1155/2009/937352

Cited by 35 publications

(31 citation statements)

References 94 publications

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“…Resistance to dual antiplatelet therapy was found in 9% of patients, a finding that is in accordance with studies in which aspirin resistance was found in 6% -27% and clopidogrel resistance was found in 15% -30% of patients [17][18][19][20][21] . However, the results of multiplate aggregometry did not differ significantly between patients with and without new ischemic lesions in the brain in the present study.…”

Section: Statistical Analysessupporting

confidence: 89%

“…Low efficacy of resistance to antiplatelet therapy could increase the risk of new ischemic lesions in the brain during and after CAS 16) . Scholars have reported a prevalence of resistance of 6% -27% in different populations for acetylsalicylic acid 17,18) and of 15% -30% for clopidogrel [19][20][21] . Selection of patients carrying a high risk of periprocedural ischemic infarction could decrease the risk of stroke, transient ischemic attack (TIA), and subsequent cognitive decline in patients undergoing CAS.…”

Section: Mrimentioning

confidence: 99%

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Laboratory-Based Markers as Predictors of Brain Infarction During Carotid Stenting: a Prospective Study

Kuliha

Roubec

Goldirova

et al. 2016

JAT

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Section: Statistical Analysessupporting

confidence: 89%

Section: Mrimentioning

confidence: 99%

Laboratory-Based Markers as Predictors of Brain Infarction During Carotid Stenting: a Prospective Study

Kuliha

Roubec

Goldirova

et al. 2016

JAT

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show abstract

“…ibuprofen, indomethacin) may interfere with aspirin's anti-thrombotic effect by blocking its docking site on COX-1 [31]. Proton pump inhibitors (PPIs), that suppress gastric acid secretion, may reduce the bioavailability of aspirin due to inactivation of the drug by gastrointestinal mucosal esterases thus reducing its absorption [32]. PPIs are substrates and competitive inhibitors of CYP2C19, the hepatic isoenzyme that plays a major role in the activation of clopidogrel.…”

Section: Reduced Bioavailability Of Anti-platelet Drugsmentioning

confidence: 99%

Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

Mărginean

Bănescu

Scridon

et al. 2016

The Journal of Critical Care Medicine

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It is well known that critically ill patients require special attention and additional consideration during their treatment and management. The multiple systems and organ dysfunctions, typical of the critical patient, often results in different patterns of enteral absorption in these patients. Anti-platelet drugs are the cornerstone in treating patients with coronary and cerebrovascular disease. Dual anti-platelet therapy with aspirin and clopidogrel is the treatment of choice in patients undergoing elective percutaneous coronary interventions and is still widely used in patients with acute coronary syndromes. However, despite the use of dual anti-platelet therapy, some patients continue to experience cardiovascular ischemic events. Recurrence of ischemic events is partly attributed to the fact that some patients have poor inhibition of platelet reactivity despite treatment. These patients are considered low-or nonresponders to therapy. The underlying mechanisms leading to resistance are not yet fully elucidated and are probably multifactorial, cellular, genetic and clinical factors being implicated. Several methods have been developed to asses platelet function and can be used to identify patients with persistent platelet reactivity, which have an increased risk of thrombosis. In this paper, the concept of anti-platelet therapy resistance, the underlying mechanisms and the methods used to identify patients with low responsiveness to anti-platelet therapy will be highlighted with a focus on aspirin and clopidogrel therapy and addressing especially critically ill patients.

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“…A concept of "aspirin resistance (AR)" describes the inability of aspirin to thromboxane (TX) biosynthesis and produces an anticipated effect on one or more in vitro tests of platelet function [2]. Clinically, aspirin resistant patients still develop adverse vascular events despite aspirin intake [3].…”

Section: Introductionmentioning

confidence: 99%

A Meta-analysis of the Association of COX-1 Gene rs3842788 and rs1330344 Polymorphism with Aspirin Resistance in Chinese

Wang¹,

Chen²,

Hu³

et al. 2017

J Med Diagn Meth

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The cyclooxygenase-1 (COX-1) gene rs3842788 variant (128G>A) and rs1330344 variant (1676G>A) have been associated with aspirin resistance in patients with cardiovascular disease. However, there is not enough evidence to demonstrate whether the A or G allele of COX-1 gene is indeed a genetic factor that can lead to aspirin resistance, with many of the studies coming to opposite conclusion. Here, we identified 10 articles on COX-1 in a literature search, and conducted a meta-analysis on the rs3842788 and rs1330344 genotype difference between aspirin resistance and aspirin sensitive patients. We found that there is no significant difference between cases and controls on GA+AA and GG genotypes of rs3842788 (OR, 1.22; 95% CI, 0.85-1.75; P, 0.29). The results provide additional evidence that rs3842788 of COX-1 gene maybe not a factor to cause aspirin resistance. However, we found that there is a significant difference between cases and controls on GA+GG and AA genotypes of rs1330344 (OR, 1.48; 95% CI, 1.15-1.90; P, 0.002). The results provide evidence that rs1330344 of COX-1 gene may be a factor to cause aspirin resistance. Therefore, more researches are needed to show the relationship between COX-1 gene and aspirin resistance.

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Aspirin Resistance

Cited by 35 publications

References 94 publications

Laboratory-Based Markers as Predictors of Brain Infarction During Carotid Stenting: a Prospective Study

Laboratory-Based Markers as Predictors of Brain Infarction During Carotid Stenting: a Prospective Study

Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

A Meta-analysis of the Association of COX-1 Gene rs3842788 and rs1330344 Polymorphism with Aspirin Resistance in Chinese

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