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 .
Effects of persistent platelet reactivity despite aspirin therapy on cardiac troponin I and creatine kinase-MB levels after elective percutaneous coronary interventions
Background Creatinine kinase-MB ( CK-MB ) and cardiac troponin I ( cTnI ) elevations are highly specific for myonecrosis after percutaneous coronary intervention ( PCI ) . Aspirin is used to prevent thrombotic complications . Several studies have shown that some individuals exhibit a reduced or completely missing antiplatelet response to aspirin . The aim of this study is to investigate the effects of platelet reactivity despite aspirin therapy on CK-MB and cTnI levels after elective percutaneous coronary interventions despite 600 mg loading dose of clopidogrel . Methods One hundred fourteen ( mean age 61.2 ± 9.3 years , 78.1 % male ) patients receiving 300 mg daily enteric coated aspirin for at least 7 days with documented coronary artery disease were included in the study . Platelet reactivity  despite aspirin was measured by platelet function analyzer (PFA)-100 collagen/epinephrine cartridge . Blood sample s for CK-MB and cTnI were obtained before and at 6 , 24 , and 36 h after the PCI . Persistent platelet reactivity was defined when collagen/epinephrine closure time < 165 s. Results A total of 87 ( 76.4 % ) patients were noted to have normal platelet reactivity ( Group A ) , and 27 ( 23.6 % ) had persistent platelet reactivity ( Group B ) . The elevations of CK-MB and cTnI levels were statistically significant within the groups ( both P < 0.001 ) . However , there were no significant differences in the CK-MB and cTnI levels of the groups at baseline and after PCI for all studied hours . Conclusion Persistent platelet reactivity was not associated with increased risk of CK-MB , cTnI elevations in low-to-intermediate risk PCI patients
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 .