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 .
Efficacy of predicting thrombotic events with combination of dual point-of-care testing (POCT) after drug-eluting stent implantation for coronary heart disease: results from the CILON-T randomized trial POCT substudy.
AIM Previous studies regarding on-treatment platelet reactivity have focused on response variability to individual antiplatelet agents . There are limited data on [ 1 ] response variability to both of these anti-platelet drugs , [ 2 ] efficacy of combining two point-of-care tests ( POCT ) simultaneously and [ 3 ] how it predicts the clinical outcome after percutaneous coronary intervention ( PCI ) . METHODS We analyzed 716 patients , enrolled in the CILON-T prospect i ve r and omized controlled trial , with both VerifyNow P2Y12 ( PRU ) and Aspirin ( ARU ) data at discharge . Patients were classified according to the tertile of PRU , ARU and the sum of the tertiles of PRU and ARU . The primary endpoint was the composite of cardiac death , nonfatal myocardial infa rct ion ( MI ) and ischemic stroke at 6 months post-PCI . RESULTS Ten patients reached the primary endpoint , four of which were nonfatal MI and six ischemic stroke . When analyzed for the primary endpoint , tertiles of ARU and PRU were not able to discriminate patients with future thrombotic events from the remainder ( p= 0.197 for ARU and 0.058 for PRU with the log-rank test , respectively ) , whereas combining the tertiles of ARU and PRU was significantly effective ( p= 0.019 for ARU+PRU with the log-rank test ) . Multivariate analysis showed that the highest tertile of the sum of ARU and PRU tertiles was the only significant predictor of future thrombotic events after PCI ( HR 6.34 , 95 % confidence interval 1.32 - 30.47 , p= 0.021 ) . CONCLUSIONS In this post-hoc analysis of the CILON-T trial , combining the results of ARU and PRU simultaneously had a significant role in discriminating patients at highest risk of future thrombotic events after PCI compared with either assay alone
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 .