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            ‐100‐measured aspirin resistance is the predominant risk factor for hospitalized cardiovascular events in aspirin‐treated patients: A 5‐year cohort study

Chen, H. Y.; Chou, Pesus

doi:10.1111/jcpt.12643

Cited by 8 publications

(5 citation statements)

References 24 publications

(42 reference statements)

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“…Platelet reactivity was measured using the PFA-100 system (Siemens, Munich, Germany), which is a convenient method for assessing platelet function for clinical evidence and has the validity correlated with clinical cardiovascular diseases. 6 –8 The time to aperture occlusion (the closure time) was recorded in seconds and was inversely related to the degree of shear-induced platelet activity. Platelet Function Analyzer-100 closure time was detected, and a closure time <193 seconds was used to define aspirin resistance according to criteria established by the manufacturer.…”

Section: Methodsmentioning

confidence: 99%

Associations Between PFA-Measured Aspirin Resistance, Platelet Count, Renal Function, and Angiotensin Receptor Blockers

Chen

Chou²

2018

Clin Appl Thromb Hemost

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Aspirin resistance is used to describe patients who are undergoing aspirin therapy but fail for the inhibition of thromboxane biosynthesis in platelets. Although the true mechanism is unclear, drug-drug interaction remains a possible factor. The study aimed to determine whether there was association between aspirin resistance and the concomitant cardiovascular medication. Using the Platelet Function Analyzer-100 system, aspirin resistance was evaluated in aspirin-treated patients from the outpatient department. The associations between aspirin resistance and their concomitant common cardiovascular medication were analyzed. Aspirin resistance was prevalent in 147 (17.7%) of 831 patients. Concomitant angiotensin receptor blocker (ARB) treatment and low platelet count were associated with aspirin response ( P = .04, .02, respectively). Multivariate logistic regression analysis results showed an association between aspirin response and ARB therapy (adjusted odds ratio [OR] 1.48; 95% confidence interval, CI: 1.08-2.18). And the association was blunted when platelet count was considered (adjusted OR 1.43, 95% CI: 0.92-2.23). In ARB-treated patients, increased creatinine and decreased hematocrit laboratory data increased the risk of aspirin resistance ( P = .02, .04, respectively), and the effect of platelet count on aspirin resistance was diminished by ARB therapy. Concomitant ARB treatment in aspirin-treated patients decreased the risk of aspirin resistance, and the effect was dependent on low platelet count. In ARB-treated patients, increased creatinine and decreased hematocrit data increased the risk of aspirin resistance. In addition, the effect of platelet count on aspirin resistance was diminished by ARB treatment.

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Section: Methodsmentioning

confidence: 99%

Associations Between PFA-Measured Aspirin Resistance, Platelet Count, Renal Function, and Angiotensin Receptor Blockers

Chen

Chou²

2018

Clin Appl Thromb Hemost

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“…Thus, if the CT value of EPI in the test is prolonged, while that of ADP is normal, then it can be inferred that the CT value of EPI is prolonged due to aspirin. However, the prolonged CT values of EPI and ADP indicate that the prolonged CT value of EPI may be attributed to other causes of platelet dysfunction 17 .…”

Section: Introductionmentioning

confidence: 96%

Changes in and significance of platelet function and parameters in Kawasaki disease

Zheng

Zhang

et al. 2019

Sci Rep

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Kawasaki disease (KD) is a systemic febrile, inflammatory vascular disease of unknown etiology. The coronary artery abnormality (CAA) caused by KD has become the most commonly acquired heart disease in children. Initial treatment of intravenous immunoglobulin (IVIG) can reduce the incidence of CAA. Thrombocytosis is common during the course of KD, but changes in and significances of platelet function and parameters are unclear. In this study, we enrolled 120 patients, including 40 patients with KD, 40 febrile controls, and 40 afebrile controls. The platelet function was assessed using the platelet function analyzer (PFA)-200. Platelet parameters, including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet hematocrit (PCT) were measured. In the febrile period, the PDW and MPV were lower in KD patients (P < 0.05). The platelet function did not change significantly during the febrile period of KD but weakened in the defervescence phase. No significant differences between the CAA and normal groups, and between IVIG resistance and response groups. The diagnostic cutoff value of the PDW level for predicting KD was 10.85 fL with a sensitivity of 55% and a specificity of 77.5% (area under curve (AUC) = 0.690, 95% confidence interval (CI): 0.574–0.806, P < 0.01). Besides, the MPV level was 9.55 fL with sensitivity of 75% and specificity of 70% (AUC = 0.733, 95%CI: 0.620–0.846, P < 0.001). This is the first longitudinal study of platelet function changes in KD patients using PFA-200. Besides, lower PDW and MPV may be available markers for early diagnosis of KD.

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“…The detection of AR has important implications to predict the clinical outcome of the disease. A 5-year follow-up study of 465 patients treated with aspirin found that multivariate logistic regression analysis showed a high association between AR and cardiovascular events (adjusted odds ratio, 4.28; 95% CI: 1.64 11.20; p 0.03) (Chen and Chou, 2017). Wang et al (2019) conducted a systematic review and meta-analysis of 35 clinical trials involving 19,025 patients with CHD to explore the relationship between the laboratory test AR and endpoint events.…”

Section: Detection and Significance Of Armentioning

confidence: 99%

Mechanism of Improving Aspirin Resistance: Blood-Activating Herbs Combined With Aspirin in Treating Atherosclerotic Cardiovascular Diseases

Zhao

Yang

2021

Front. Pharmacol.

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Atherosclerotic thrombotic disease continues to maintain a high morbidity and mortality rate worldwide at present. Aspirin, which is reckoned as the cornerstone of primary and secondary prevention of atherosclerotic cardiovascular diseases (ASCVDs), has been applied in clinics extensively. However, cardiovascular events continue to occur even though people utilize aspirin appropriately. Therefore, the concept of aspirin resistance (AR) was put forward by scholars, which is of great significance for the prediction of the clinical outcome of diseases. The pathogenesis of AR may be incorporated with low patient compliance, insufficient dose, genetic polymorphism, increased platelet transformation, inflammation, and the degenerative changes and calcification of platelets. The improvement of AR in the treatment of ASCVDs has gradually become a research hot spot in recent years. Traditional Chinese medicine (TCM) regards individuals as a whole and treats them from a holistic view, which has been found to have advantages in clinical studies on the treatment of AR. Many kinds of blood-activating TCM have the effect of improving AR. The potential mechanism for the improvement of AR by blood-activating herbs combined with aspirin was explored. The combination of blood-activating herbs and aspirin to improve AR is likely to turn into a hot topic of research in the future.

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PFA ‐100‐measured aspirin resistance is the predominant risk factor for hospitalized cardiovascular events in aspirin‐treated patients: A 5‐year cohort study

Cited by 8 publications

References 24 publications

Associations Between PFA-Measured Aspirin Resistance, Platelet Count, Renal Function, and Angiotensin Receptor Blockers

Associations Between PFA-Measured Aspirin Resistance, Platelet Count, Renal Function, and Angiotensin Receptor Blockers

Changes in and significance of platelet function and parameters in Kawasaki disease

Mechanism of Improving Aspirin Resistance: Blood-Activating Herbs Combined With Aspirin in Treating Atherosclerotic Cardiovascular Diseases

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