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 .
Relationship between aspirin and clopidogrel responses in acute coronary syndrome and clinical predictors of non response.
OBJECTIVES We have prospect ively investigated the association between aspirin and clopidogrel responses and the clinical predictors of non response . METHODS 635 Non ST Elevation Acute Coronary Syndrome ( NSTE ACS ) patients were included and received loading doses of 250 mg aspirin and 600 mg clopidogrel . We analyzed post-treatment maximal intensity of arachidonic acid and ADP-induced platelet aggregation ( AA-Ag and ADP-Ag ) and Platelet Reactivity Index of VAsodilator-Stimulated Phosphoprotein ( PRI VASP ) . Aspirin and clopidogrel non responses were defined respectively by AA-Ag>30 % and ADP-Ag>70 % . RESULTS Aspirin non responders patients had significantly higher ADP-Ag and PRI VASP than aspirin responders : 63.7+/-15.9 % vs 55+/-19 % ( p=0.0001 ) and 73.6+/-13.3 % vs 53+/-23 % ( p=0.0001 ) respectively and the rate of clopidogrel non responders was higher among aspirin non responders than aspirin responders : 36.7 % vs 22.7 % ( p=0.003 ) . In addition , clopidogrel non responders had significantly higher AA-Ag and rate of aspirin non responders than clopidogrel responders : 21.6+/-24 % vs 10.3+/-19 % ( p=0.0001 ) and 22.8 % vs 12.9 % ( p=0.003 ) respectively . Age and Body Mass Index ( BMI ) were significantly associated with non response to Clopidogrel ( p=0.035 and 0.02 respectively ) and diabetes mellitus by trend ( p=0.07 ) . CONCLUSION We observed a relationship between aspirin and clopidogrel non responses and an association between age , BMI and diabetes mellitus and clopidogrel response
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 .