Platelet function in patients with acute coronary syndrome (ACS) predicts recurrent ACS

Fuchs, Ingrid; Frossard, Martin; Spiel, Alexander; Riedmüller, Eva; Laggner, Anton N.; Jilma, Bernd

doi:10.1111/j.1538-7836.2006.02239.x

Cited by 117 publications

(94 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, Gianetti and colleagues demonstrated an independent positive relation of aspirin resistance, estimated by the PFA-100, and 6-mo clinical recurrence of symptoms in 175 patients with stable or unstable coronary artery disease who underwent successful coronary stenting. 6 Another report by Fuchs et al, 7 with a study population of 208 patients with unstable coronary artery disease, also yielded a significant independent association of aspirin resistance, assessed by PFA-100, and major atherothrombotic long-term events.…”

Section: Discussionmentioning

confidence: 99%

“…However, Fucsh et al, in a study of patients with ACS, have shown that inclusion of von Willebrand factor levels in a multivariate Cox regression model did not alter the predictive value of a low PFA-100 CEPI-CT for the incidence of long-term recurrent instability. 7 Third, patients with NSTE-ACS, and therefore probably with some degree of platelet hyperactivity, were included in this study. Subsequently, low values of PFA-100 in the study patients may reflect a transient phenomenon of the acute phase.…”

Section: Limitations Of the Studymentioning

confidence: 99%

See 1 more Smart Citation

The Impact of Aspirin Resistance on the Long‐term Cardiovascular Mortality in Patients with Non‐ST Segment Elevation Acute Coronary Syndromes

Foussas¹,

Zairis²,

Tsirimpis³

et al. 2009

Clinical Cardiology

View full text Add to dashboard Cite

Background: Aspirin resistance has been associated with an adverse long-term outcome in patients with atherosclerotic coronary artery disease, but more studies are needed. Hypothesis: The aim of this study was to investigate the impact of aspirin resistance, assessed by the Platelet Function Analyzer-100 (PFA-100) (Dade Behring Inc., Deerfield, Ill., USA) on the long-term prognosis in patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS). Methods: A total of 496 consecutive patients were studied. The 1-y incidence of cardiovascular death was the prespecified study endpoint. The patients were divided, according to the values of PFA-100 collagen epinephrine closure time (CEPI-CT) upon presentation, into aspirin sensitives (those with a PFA-100 CEPI-CT >193 sec) and aspirin resistants (those with a PFA-100 CEPI-CT ≤193 sec). Results: Aspirin resistants were younger (p-value = 0.04), and less frequently hypertensives (p-value = 0.05) or diabetics (p-value = 0.04) than aspirin sensitives. By 1 y, the incidence of cardiovascular deaths in the entire cohort was 12.9% (64/496), and aspirin resistants were at significantly higher risk of cardiovascular death (23.1% versus 9.6%; hazard ratio [HR] = 2.6; 95% confidence interval [CI] = 1.6-4.3; p-value <0.001), than aspirin sensitives. By multivariate Cox regression analysis, aspirin resistance (a PFA-100 CEPI-CT ≤193 sec) was among the most potent predictors of the 1-y incidence of cardiovascular death (HR = 2.8; 95% CI = 1.7-4.6; p-value <0.001). Conclusion: According to the present data, aspirin resistance, assessed by the PFA-100, is an independent predictor of long-term cardiovascular mortality in patients with NSTE-ACS.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Limitations Of the Studymentioning

confidence: 99%

The Impact of Aspirin Resistance on the Long‐term Cardiovascular Mortality in Patients with Non‐ST Segment Elevation Acute Coronary Syndromes

Foussas¹,

Zairis²,

Tsirimpis³

et al. 2009

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…Eight studies were eliminated because they were not prospective studies, 4 because they reported only clopidogrel resistance, 2 because they did not evaluate clinical cardiovascular recurrences during the follow-up but only surrogate markers, and 1 because only a meeting abstract was available. As a result, a total of 11 prospective studies were included in the meta-analysis [8][9][10][11][12][13][14][15][16][17][18].…”

Section: Search Resultsmentioning

confidence: 99%

Residual platelet reactivity on aspirin therapy and recurrent cardiovascular events — A meta-analysis

Sofi

Marcucci

Gori

et al. 2008

International Journal of Cardiology

View full text Add to dashboard Cite

Background: Recently, a growing body of evidence on the possible role of residual platelet reactivity (RPR) in affecting clinical events has accumulated. The aim of this study was to systematically assess the relationship between RPR on acetylic salicylic acid (ASA) therapy and the occurrence of recurrent events in a meta-analysis of prospective studies. Methods: A systematic literature search of MEDLINE, EMBASE, Science Citation Index, the Cochrane Systematic Review Database and bibliographies of retrieved articles through May 2007 was conducted. Studies were included if they analysed RPR in coronary heart disease patients in relation to the occurrence of adverse coronary events during follow-up. Results: Eleven prospective studies, incorporating 1952 patients with coronary heart disease followed for a time ranging from 6 days to 4 years, met the inclusion criteria. The pooled analysis demonstrated a significantly increased relative risk of adverse clinical events during follow-up for patients with RPR on ASA therapy (RR: 3.11, 95%CI 1.88-5.15; p b 0.0001). Moreover, the association between RPR and cardiovascular recurrences remained to be statistically significant even when subgroup analyses performed according to the duration of follow-up, ASA dosage, characteristics of the study population, and laboratory method were conducted. Conclusions: The present meta-analysis documents a significant association between RPR on ASA treatment and recurrent cardiovascular events. More prospective studies are needed to determine the independent prognostic importance of RPR during aspirin therapy and possible benefit of individually tailored anti-platelet treatment strategies in these patients.

show abstract

“…Therefore, closure time, as determined on the PFA-100®, is strongly influenced by the amount of von Willebrand factor (vWF) [12]. Increased plasma vWF levels and a higher vWF-ristocetin cofactor activity have been related to shorter CT values on the PFA-100®, and these patients may be considered poor responders to ASA [13,14]. In our study, the agreement between the LTA and PFA-100® test results was poor, as only two patients were identified as non-responders using both methods (2.0%).…”

Section: Discussionmentioning

confidence: 99%

Variability of non-response to aspirin in patients with peripheral arterial occlusive disease during long-term follow-up

et al. 2009

View full text Add to dashboard Cite

Edelgard Lindhoff-Last. Variability of non-response to aspirin in patients with peripheral arterial occlusive disease during long-term follow-up. Annals of Hematology, Springer Verlag, 2009, 88 (10) Abstract Non-responsiveness to aspirin as detected by laboratory tests may identify patients at high risk for future vascular events. The aim of this prospective study was to evaluate whether non-responsiveness to aspirin is stable over time. Ninety-eight patients with stable peripheral arterial occlusive disease (PAOD) treated with 100 mg/d aspirin were followed over a median timeframe of 17 months. Platelet function tests were performed initially and at follow-up using arachidonic acid-induced light transmittance aggregometry (LTA) in native platelet-rich plasma with the Behring Coagulation Timer® and by measuring the collagen−epinephrine closure time (CT) on a Platelet Function Analyzer (PFA-100®). When determining platelet function using LTA, four patients (4.1%) had residual platelet function (i.e., MaxAggr ≥78%) despite aspirin treatment, whereas, according to the PFA-100® results, 12 patients (12.2%) were identified as nonresponders (i.e., CT <192 s). Fifty-seven patients who were still under treatment with 100 mg/d aspirin at the time of follow-up provided a second blood sample. Further platelet function tests with the PFA-100® system identified a persistent non-responsiveness to aspirin over time in three patients (5.3%) whereas four (7.0%) and 15 (26.3%) patients had changes in response status when platelet function was assessed by LTA and on the PFA-100®, respectively. We conclude that true non-responsiveness to aspirin is a rare phenomenon in stable PAOD patients.Furthermore, we conclude that in a number of patients, aspirin non-responsiveness is not stable over time.

show abstract

Platelet function in patients with acute coronary syndrome (ACS) predicts recurrent ACS

Cited by 117 publications

References 27 publications

The Impact of Aspirin Resistance on the Long‐term Cardiovascular Mortality in Patients with Non‐ST Segment Elevation Acute Coronary Syndromes

The Impact of Aspirin Resistance on the Long‐term Cardiovascular Mortality in Patients with Non‐ST Segment Elevation Acute Coronary Syndromes

Residual platelet reactivity on aspirin therapy and recurrent cardiovascular events — A meta-analysis

Variability of non-response to aspirin in patients with peripheral arterial occlusive disease during long-term follow-up

Contact Info

Product

Resources

About