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 .
Results of the BRAT study--a pilot study investigating the possible significance of ASA nonresponsiveness on the benefits and risks of ASA on thrombosis in patients undergoing coronary artery bypass surgery.
BACKGROUND Several studies suggest that acetylsalicylic acid ( ASA ) is less effective in preventing thrombotic events in ASA nonresponder patients . If so , the thrombotic event rate in ASA nonresponders should be higher than in ASA responders . OBJECTIVE To conduct a prospect i ve , multicentre observational pilot study to determine the thrombotic event rates in ASA responders and nonresponders . PATIENTS AND METHODS Patients undergoing nonurgent coronary artery bypass grafting ( CABG ) who were prescribed 325 mg ASA/day were recruited . Patients were classified as an ASA responder or nonresponder based on the ASA effect ( or lack thereof ) on their bleeding times . All thrombotic events that occurred in the two years following CABG were recorded . These data were stored in a blinded fashion until the last patient follow-up , and then adjudicated by a validation committee . RESULTS A total of 289 patients recruited at three sites completed the two-year follow-up . Of these patients , 45.3 % were classified as ASA responders and 54.7 % were classified as ASA nonresponders . Of ASA responders , 6.9 % had thrombotic events compared with 9.5 % of the ASA nonresponders , but this difference was not significant ( P=0.526 ) . CONCLUSIONS While ASA responder or nonresponder status did not appear to affect the thrombotic event rate in patients undergoing nonurgent CABG , the possibility that ASA responder or nonresponder status affects the thrombotic event rate in more acutely ill CABG patients can not be excluded
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 .