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 effects of aspirin and clopidogrel response on myonecrosis after percutaneous coronary intervention: a BRIEF-PCI (Brief Infusion of Intravenous Eptifibatide Following Successful Percutaneous Coronary Intervention) trial substudy.
OBJECTIVES The purpose of this study was to evaluate the effects of aspirin and clopidogrel response on  myonecrosis after percutaneous coronary intervention ( PCI ) with glycoprotein ( GP ) IIb/IIIa blockade . BACKGROUND Aspirin and clopidogrel resistance is increasingly recognized , but its effects on PCI outcomes with GP IIb/IIIa blockade are unknown . METHODS This was a prospect i ve , pre-specified sub study of the BRIEF-PCI ( Brief Infusion of Intravenous Eptifibatide Following Successful Percutaneous Coronary Intervention ) trial , which r and omized 624 patients to 18-h or < 2-h eptifibatide infusion after uncomplicated PCI . To be eligible , patients must have been pre-treated with aspirin ( > or=5 days ) and clopidogrel ( 75 mg/day > or=5 days , 300 mg loading > or=6 h , or 600 mg loading > or=2 h ) and must not have received GP IIb/IIIa inhibitors within 48 h. Verify-Now Aspirin and Clopidogrel ( P2Y(12 ) ) assays were performed at baseline before PCI . Patients with aspirin reaction unit ( ARU ) > or=550 were labeled as aspirin resistant . Clopidogrel low-responders were defined as those in the lowest quartile of platelet inhibition . The primary end point was the prevalence of myonecrosis within 24 h after PCI . RESULTS We enrolled 209 patients into our sub study , of which 185 had aspirin response assessed , 198 had clopidogrel response assessed , and 174 had both assessed . There were 4.9 % who were aspirin resistant . Clopidogrel low-responders were defined as those in the lowest quartile with platelet inhibition < 19 % . Only 1.1 % had both aspirin resistance and low clopidogrel response . There was no difference in myonecrosis prevalence among aspirin-resistant compared with aspirin-sensitive patients ( 11.1 % vs. 27.8 % , p = 0.259 ) or among clopidogrel low-responders compared with clopidogrel responders ( 23.5 % vs. 29.3 % , p = 0.433 ) . CONCLUSIONS Aspirin and clopidogrel response did not affect myonecrosis prevalence amongst patients who received eptifibatide for 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 .