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 ' .
Study -level effect sizes were generally small and absolute outcome risk was not substantially different between ' aspirin resistant ' and ' aspirin sensitive ' design ations .
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 .
BACKGROUND The 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 .
OBJECTIVES To review systematic ally the clinical effectiveness and cost-effectiveness evidence regarding the association between PFT design ation 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 .
[Study on the relationship between aspirin resistance and incidence of myonecrosis after non-emergent percutaneous coronary intervention].
OBJECTIVE To investigate the occurrence of aspirin resistance in coronary heart disease ( CHD ) patients and its influence on myonecrosis among patients undergoing non-emergent percutaneous coronary intervention ( PCI ) . METHODS 256 CHD patients who have been on aspirin ( 100 mg/d ) for at least 7 days were recruited based on  aspirin responsiveness determination . All the patients were divided into two groups : aspirin-resistant group and aspirin-sensitive group . For all patients scheduled for non-emergent PCI , a loading dose of 300 mg of clopidogrel was given at least 12 h before PCI and a 75 mg maintenance dose was given every morning before and after PCI . The incidence of myonecrosis was evaluated by the levels of creatine kinase-myocardial b and ( CK-MB ) and troponin I ( TnI ) before and after PCI . RESULTS Aspirin resistance was found in 67 ( 26.2 % ) patients and 189 ( 73.8 % ) patients were aspirin-sensitive . There was a significantly higher proportion of female subjects in the aspirin-resistant group . The incidence of any CK-MB elevation was 38 ( 56.7 % ) in aspirin-resistant group and 42 ( 22.2 % ) in aspirin-sensitive group ( P < 0.01 ) . The elevation of TnI was observed in 41 ( 61.2 % ) of the aspirin-resistant group and in 67 ( 35.4 % ) of the aspirin-sensitive group ( P < 0.05 ) . Multivariate analysis revealed that aspirin resistance was an independent predictor for CK-MB elevation after PCI ( OR = 2.5 ; 95 % CI 1.5 to 6.5 ; P < 0.05 ) . CONCLUSION Aspirin resistance exists in some CHD patients , which increases the risk of myonecrosis following non-emergent PCI
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 ' .
Study -level effect sizes were generally small and absolute outcome risk was not substantially different between ' aspirin resistant ' and ' aspirin sensitive ' design ations .
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 .
BACKGROUND The 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 .
OBJECTIVES To review systematic ally the clinical effectiveness and cost-effectiveness evidence regarding the association between PFT design ation 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 .