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 .
Platelet activation predicts recurrent ischemic events after percutaneous coronary angioplasty: a 6 months prospective study.
INTRODUCTION An increasing amount of evidence indicates that platelet reactivity , despite a st and ard anti-thrombotic therapy , is a potential risk factor for recurrent myocardial ischemia in patients with coronary artery disease . We now hypothesize that this condition , measured by collagen-epinephrine ( CEPI ) or collagen-ADP ( CADP ) closure times ( CT ) by Platelet Function Analyzer ( PFA-100 ) , may predict the recurrence of coronary events after percutaneous coronary intervention ( PCI ) . MATERIAL S AND METHODS CEPI and CADP-CT  were measured 30+/-8 h after PCI in 175 consecutive patients admitted with a diagnosis of stable angina ( n=94 ) or acute coronary syndromes ( n=81 ) and prospect ively followed up for a mean period of 6 months . We stratified the patients in accordance to both the CEPI-CT ( 190 s ) , reflecting the intensity of cycloxygenase inhibition by aspirin and the distribution into quartiles for CADP-CT . RESULTS CEPI-CT<190 s as well as CADP-CT<82 s were associated with a higher rate of clinical recurrence ( hazard ratio 8.5 , p<0.001 and 22.9 , p<0.001 , respectively ) . Multivariate analysis after adjustment for other risk factors confirmed that the lowest CADP-CT quartile significantly correlates with the risk of recurrent coronary events ( hazard ratio 36.5 , p<0.01 ) , as well as CEPI-CT<190 s ( hazard ratio 6.7 , p=0.01 ) . CONCLUSIONS An enhanced platelet function after PCI when measured under high shear rates by PFA-100 is an independent predictor of a worst clinical outcome , even during a short term follow-up and may help in patients risk stratification
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 .