Association of Recurrent Cerebral Infarction With Adenosine Diphosphate– and Collagen-Induced Platelet Aggregation in Patients Treated With Ticlopidine and/or Aspirin

Abumiya, Takeo; Houkin, Kiyohiro

doi:10.1016/j.jstrokecerebrovasdis.2010.01.013

Cited by 3 publications

(13 citation statements)

References 27 publications

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“…Where reported, mean ages of patients ranged from 60 to 75 years, with most means around the mid to late 60s or early 70s. There were more men than women in 14 out of 15 studies that reported on this, 88,90,93,95,112,121,125,147,149,155,159,163,174,187,201 with proportions of men ranging from 53% to 81%. Only one study 142 included more women (54%).…”

Section: Population and Test Characteristicsmentioning

confidence: 97%

“…Of the 108 included studies with test data linked to clinical outcome data, 57 studies reported on a patient group solely or predominantly receiving aspirin as monotherapy at the time of testing, 46,76,86,88,90,92,93,95,99,105,[108][109][110]112,113,[115][116][117][118]121,123,125,127,128,132,133,135,137,138,142,[144][145][146][147][148][149][150][151][152][153][154][155]159,[162][163][164]166,168,169,171,174,186,187,189,193,195,196,…”

Section: Study Mappingmentioning

confidence: 99%

“…Nineteen studies 88,90,93,95,112,113,121,125,142,147,149,155,159,162,164,169,174,187,201 were identified in this category, four of which were reported in abstract form only, 162,164,169,174 and one as a letter. 88 Populations had CAD (six studies In 12 studies 88,90,95,112,121,142,147,155,159,162,164,174 it appeared that patients were exclusively on monotherapy both at the time of the PFT and during follow-up.…”

Section: Population and Test Characteristicsmentioning

confidence: 99%

“…88 Populations had CAD (six studies In 12 studies 88,90,95,112,121,142,147,155,159,162,164,174 it appeared that patients were exclusively on monotherapy both at the time of the PFT and during follow-up. In two studies, 113,125 around 4% and 5% of patients were on dual therapy (aspirin + clopidogrel) at the time of the PFT.…”

Section: Population and Test Characteristicsmentioning

confidence: 99%

“…There were no details on dose in one study. 95 Details were variable across studies regarding the length of time patients had been receiving aspirin therapy, with some noting a minimum period and some whether patients were chronic or first-time users, but many giving no details (see Table 4). No study stated whether aspirin was provided in enteric or plain form, though one study 93 noted that aspirin was in chewable form.…”

Section: Population and Test Characteristicsmentioning

confidence: 99%

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The prognostic utility of tests of platelet function for the detection of ‘aspirin resistance’ in patients with established cardiovascular or cerebrovascular disease: a systematic review and economic evaluation

Dretzke

Riley

Lordkipanidzé

et al. 2015

Health Technology Assessment

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BackgroundThe use of aspirin is well established for secondary prevention of cardiovascular disease. However, a proportion of patients suffer repeat cardiovascular events despite being prescribed aspirin treatment. It is uncertain whether or not this is due to an inherent inability of aspirin to sufficiently modify platelet activity. This report aims to investigate whether or not insufficient platelet function inhibition by aspirin (‘aspirin resistance‘), as defined using platelet function tests (PFTs), is linked to the occurrence of adverse clinical outcomes, and further, whether or not patients at risk of future adverse clinical events can be identified through PFTs.ObjectivesTo review systematically the clinical effectiveness and cost-effectiveness evidence regarding the association between PFT designation of ‘aspirin resistance’ and the risk of adverse clinical outcome(s) in patients prescribed aspirin therapy. To undertake exploratory model-based cost-effectiveness analysis on the use of PFTs.Data sourcesBibliographic databases (e.g. MEDLINE from inception and EMBASE from 1980), conference proceedings and ongoing trial registries up to April 2012.MethodsStandard systematic review methods were used for identifying clinical and cost studies. A risk-of-bias assessment tool was adapted from checklists for prognostic and diagnostic studies. (Un)adjusted odds and hazard ratios for the association between ‘aspirin resistance’, for different PFTs, and clinical outcomes are presented; however, heterogeneity between studies precluded pooling of results. A speculative economic model of a PFT and change of therapy strategy was developed.ResultsOne hundred and eight relevant studies using a variety of PFTs, 58 in patients on aspirin monotherapy, were analysed in detail. Results indicated that some PFTs may have some prognostic utility, i.e. a trend for more clinical events to be associated with groups classified as ‘aspirin resistant’. Methodological and clinical heterogeneity prevented a quantitative summary of prognostic effect. Study-level effect sizes were generally small and absolute outcome risk was not substantially different between ‘aspirin resistant’ and ‘aspirin sensitive’ designations.No studies on the cost-effectiveness of PFTs for ‘aspirin resistance’ were identified. Based on assumptions of PFTs being able to accurately identify patients at high risk of clinical events and such patients benefiting from treatment modification, the economic model found that a test–treat strategy was likely to be cost-effective. However, neither assumption is currently evidence based.LimitationsPoor or incomplete reporting of studies suggests a potentially large volume of inaccessible data. Analyses were confined to studies on patients prescribed aspirin as sole antiplatelet therapy at the time of PFT. Clinical and methodological heterogeneity across studies precluded meta-analysis. Given the lack of robust data the economic modelling was speculative.ConclusionsAlthough evidence indicates that some PFTs may have some prognostic value, methodological and clinical heterogeneity between studies and different approaches to analyses create confusion and inconsistency in prognostic results, and prevented a quantitative summary of their prognostic effect. Protocol-driven and adequately powered primary studies are needed, using standardised methods of measurements to evaluate the prognostic ability of each test in the same population(s), and ideally presenting individual patient data. For any PFT to inform individual risk prediction, it will likely need to be considered in combination with other prognostic factors, within a prognostic model.Study registrationThis study is registered as PROSPERO 2012:CRD42012002151.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Population and Test Characteristicsmentioning

confidence: 97%

Section: Study Mappingmentioning

confidence: 99%

Section: Population and Test Characteristicsmentioning

confidence: 99%

Section: Population and Test Characteristicsmentioning

confidence: 99%

Section: Population and Test Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

The prognostic utility of tests of platelet function for the detection of ‘aspirin resistance’ in patients with established cardiovascular or cerebrovascular disease: a systematic review and economic evaluation

Dretzke

Riley

Lordkipanidzé

et al. 2015

Health Technology Assessment

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Aspirin plus dipyridamole has the highest surface under the cumulative ranking curves (SUCRA) values in terms of mortality, intracranial hemorrhage, and adverse event rate among 7 drug therapies in the treatment of cerebral infarction

Zhang

Liu²

2018

Medicine

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Interaction of the Humoral Agonist During the Platelets Activation in Patients with Chronic Cerebral Ischemia

Barinov

Mamedaliyeva²,

Твердохлеб

2015

ARAMS

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Признавая мультифакториальность патогенеза хронической ишемии головного мозга (ХИМ) и желание исследователей выделить ведущие патогенетические факторы заболевания, de facto приходится сталкиваться всего лишь с намерениями обосновать необходимость фармакологической коррекции тех или иных патохимических нарушений [1]. Какие нарушения в действительности являются ведущими в патогенезе ХИМ, традиционно обсуждается формально. Как следствие, для лечения таких пациентов характерна полипрагмазия. Данной ситуации можно из-

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Association of Recurrent Cerebral Infarction With Adenosine Diphosphate– and Collagen-Induced Platelet Aggregation in Patients Treated With Ticlopidine and/or Aspirin

Cited by 3 publications

References 27 publications

The prognostic utility of tests of platelet function for the detection of ‘aspirin resistance’ in patients with established cardiovascular or cerebrovascular disease: a systematic review and economic evaluation

The prognostic utility of tests of platelet function for the detection of ‘aspirin resistance’ in patients with established cardiovascular or cerebrovascular disease: a systematic review and economic evaluation

Aspirin plus dipyridamole has the highest surface under the cumulative ranking curves (SUCRA) values in terms of mortality, intracranial hemorrhage, and adverse event rate among 7 drug therapies in the treatment of cerebral infarction

Interaction of the Humoral Agonist During the Platelets Activation in Patients with Chronic Cerebral Ischemia

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