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Am J Med. 2007 Jul;120(7):631-5.

Aspirin resistance and adverse clinical events in patients with coronary artery disease.

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  • 1Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China. whchen@hku.hk

Abstract

PURPOSE:

We sought to determine the clinical significance of aspirin resistance measured by a point-of-care assay in stable patients with coronary artery disease (CAD).

METHODS:

We used the VerifyNow Aspirin (Accumetrics Inc, San Diego, Calif) to determine aspirin responsiveness of 468 stable CAD patients on aspirin 80 to 325 mg daily for > or =4 weeks. Aspirin resistance was defined as an Aspirin Reaction Unit > or =550. The primary outcome was the composite of cardiovascular death, myocardial infarction (MI), unstable angina requiring hospitalization, stroke, and transient ischemic attack.

RESULTS:

Aspirin resistance was noted in 128 (27.4%) patients. After a mean follow-up of 379+/-200 days, patients with aspirin resistance were at increased risk of the composite outcome compared to patients who were aspirin-sensitive (15.6% vs 5.3%, hazard ratio [HR] 3.12, 95% confidence intervals [CI], 1.65-5.91, P < .001). Cox proportional hazard regression modeling identified aspirin resistance, diabetes, prior MI, and a low hemoglobin to be independently associated with major adverse long-term outcomes (HR for aspirin resistance 2.46, 95% CI, 1.27-4.76, P = .007).

CONCLUSIONS:

Aspirin resistance, defined by an aggregation-based rapid platelet function assay, is associated with an increased risk of adverse clinical outcomes in stable patients with CAD.

PMID:
17602938
DOI:
10.1016/j.amjmed.2006.10.021
[PubMed - indexed for MEDLINE]
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