Aspirin Resistance Incidence and Associations Between Aspirin Effect and Outcomes in Cardiac Surgery

Nicola, Henrique; Ho, Kwok M.

doi:10.1016/j.athoracsur.2019.04.114

Cited by 9 publications

(10 citation statements)

References 13 publications

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“…Although it is an important prescribed drug for cardiovascular and cerebrovascular diseases, resistance to its effects limits its efficiency. 9 , 10 There are reported 5%–45% patients with aspirin resistance; 11 in addition, the following factors contribute to aspirin resistance: the COX-1 polymorphisms of C50 T, -A842G, and A1676G; the COX-2 polymorphism of −765; single nucleotide polymorphisms, such as the rs1126643 of the GPIa and the rs5918 of GPIIIa, 12 , 13 diseases like inflammation (mediated by oxidative stress-induced 8-isoprostaglandin F2α, white blood cell count, monocyte count, and macrophages), 13 , 14 diabetes (related to waist circumference, HOMA-IR, QUICKI, and leptin), 15 obesity, 16 , 17 patient compliance and miRNAs. 18 , 19 In this study, we compared the control group and aspirin-resistant group and found that PAg-ADP% and platelet counts were significantly different.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Risk Factors for Drug Resistance of Dual Anti Platelet Therapy After PCI

Zhang

Dong

et al. 2022

Clin Appl Thromb Hemost

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Since aspirin and clopidogrel are the widely and conventionally used drugs to treat acute myocardial infarction after percutaneous coronary intervention (PCI), it is important to explore potential risk factors of their resistance. The platelet aggregation rate with arachidonic acid (AA, PAg-AA%) and adenosine diphosphate (ADP, PAg-ADP%) of 219 PCI patients were measured after standard treatment for 24 h. The disease history and laboratory data (before PCI) were obtained. We found 101 (46.12%) patients to be aspirin-resistant, and PAg-ADP% was the most prominent risk factor of aspirin resistance. Clopidogrel resistance was present in 157 of 219 patients. Patients in the clopidogrel-resistant group carried more CYP2C19*3 or *2, which was associated with higher clopidogrel resistance in this group (69.11%, 47/68) than in the control group (64.29%, 36/56). Platelet count (109/L) and hemoglobin (g/L) were the prominent risk factors of clopidogrel resistance. Among the 219 patients, 98 showed dual antiplatelet drug resistance, for which platelet count (109/L) and monocyte count (g/L) were the risk factors. Aspirin resistance was found to usually accompany clopidogrel resistance.

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Section: Discussionmentioning

confidence: 99%

Assessment of Risk Factors for Drug Resistance of Dual Anti Platelet Therapy After PCI

Zhang

Dong

et al. 2022

Clin Appl Thromb Hemost

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“…We thank Petricevic et al (1) for their interest in our work (2) and their pertinent questions. Firstly, how to define aspirin resistance is contentious and to the best of our knowledge, there is still no consensus on which platelet function test is the best, let alone what cut point for each platelet function test is considered most appropriate in correlation to meaningful clinical outcomes.…”

Section: Aspirin Resistance Significantly Influences Clinical and Economic Burden In Cardiac Surgery Patients (Reply)mentioning

confidence: 93%

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Nicola

2020

The Annals of Thoracic Surgery

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“…It measures platelet aggregation by continuously monitoring electrical impedance changes due to activation of platelets and adhesion to the metal sensor electrodes in 3-5 separate channels in multiple electrode aggregometry (MEA). [14][15][16][17][18][19][20][21] Whole blood sample is used in each channel with the addition of arachidonic acid to assess the effect of aspirin (ASPItest ), ADP for platelet P2Y12 inhibitor effect (ADPtest ) or thrombin receptor agonist peptide to measure glycoprotein IIb/IIIa inhibitor effect (TRAPtest ). 14,[19][20][21] Collagen can also be used as a substitute for arachidonic acid to assess the effect of aspirin.…”

Section: Impedance Platelet Aggregometrymentioning

confidence: 99%

Antiplatelet Resistance in Coronary Artery Bypass Grafting: A Systematic Review

Thet

Khosravi

Egbulonu

et al. 2022

Preprint

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Introduction: Aspirin and clopidogrel are the most commonly used antiplatelet agents, either alone or as dual therapy, in patients undergoing CABG surgery to reduce organ ischaemia and mortality. The systematic review aims to explore the resistance to the antiplatelet agents, how to assess it, and the effect of resistance on the outcomes in CABG surgery. Materials & methods: A systematic search is carried out on MEDLINE via Ovid, PubMed, Embase, the Cochrane Library Database and Google Scholar until November 2021 to look for studies evaluating the antiplatelet resistance in patients undergoing both on-pump and off-pump CABG surgery. Only high-quality studies were included after the risk of bias assessment. Results: A total of 17 studies, of which 3 randomised controlled trials and 14 observational studies were included after inclusion criteria is applied. The incidence of aspirin resistance ranges from 11-51.5%, whereas, clopidogrel resistance is 22%. A wide variety of different assessment methods for antiplatelets are reported. Antiplatelet resistance is a predictor of vein graft occlusion, with up to 13 fold increase in occlusion rate. There is no overall effect of aspirin resistance on mortality, stroke or myocardial infarction, however, clopidogrel resistance leads to higher mortality, MI and target vessel revascularisations. The effect of cardiopulmonary bypass on antiplatelet resistance is not clear. Conclusion: There is no uniform definition of antiplatelet resistance. Assessment methods differ greatly and their results are not interchangeable. Antiplatelet resistance is associated with a higher rate of graft occlusion in CABG patients. Aspirin resistance does not influence overall adverse outcomes, however, clopidogrel resistance leads to worse outcomes.

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Aspirin Resistance Incidence and Associations Between Aspirin Effect and Outcomes in Cardiac Surgery

Cited by 9 publications

References 13 publications

Assessment of Risk Factors for Drug Resistance of Dual Anti Platelet Therapy After PCI

Assessment of Risk Factors for Drug Resistance of Dual Anti Platelet Therapy After PCI

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Antiplatelet Resistance in Coronary Artery Bypass Grafting: A Systematic Review

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