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 .
The impact of oral antiplatelet responsiveness on the long-term prognosis after coronary stenting.
BACKGROUND Decreased responsiveness to oral antiplatelet drug therapy has been associated with an adverse outcome after coronary stenting ( CS ) , but more studies are needed . The purpose of the present study was to prospect ively evaluate this issue . METHODS A total of 612 consecutive patients with stable or unstable coronary artery disease who underwent CS after at least 12 hours of aspirin and clopidogrel loading were studied . The study population was divided into responders and nonresponders to oral antiplatelet therapy , according to the values of preprocedural Platelet Function Analyzer-100 ( Dade Behring , Marburg , Germany ) collagen epinephrine closure time ( CEPI-CT ) . In particular , responders were considered as patients with a CEPI-CT > 193 seconds and nonresponders as those with a CEPI-CT < or = 193 seconds . The 1-year incidence of the composite of cardiac death and rehospitalization for nonfatal myocardial infa rct ion was the prespecified primary study end point . RESULTS At 1 year , 9.1 % of patients reached the primary end point . Nonresponders to oral antiplatelet therapy were at significantly higher risk for the primary end point ( 18.7 % vs 7.6 % ) than responders . Nonresponsiveness to oral antiplatelet therapy  was a predictor of the primary end point by both univariate ( hazard ratio 2.7 , 95 % CI 1.6 - 4.5 , P < .001 ) and multivariate ( hazard ratio 2.5 , 95 % CI 1.6 - 3.8 , P < .001 ) Cox regression analysis . CONCLUSION Based on the present data , preprocedural responsiveness to oral antiplatelet therapy , assessed by Platelet Function Analyzer-100 CEPI-CT , is an independent predictor of long-term outcome after CS
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 .