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 .
Aspirin Responsiveness in Acute Brain Ischaemia: Association with Stroke Severity and Clinical Outcome
Purpose : Platelets play a critical role in the pathogenesis of acute brain ischaemia . We studied the association between the degree of inhibition of platelet function by aspirin ( ASA ) and the severity and outcome of acute brain ischaemia . Methods : Platelet responsiveness to ASA was assessed in patients with acute brain ischaemia , treated with ASA since hospital admission . The degree of ASA responsiveness was assessed by optical aggregometry and categorized into patients with good response , partial response and complete unresponsiveness to ASA ( good responders , partial responders and non-responders , respectively ) . An additional evaluation of responsiveness to ASA was performed by Impact-R ( cone and platelet analyzer ) . Patients underwent serial clinical assessment during hospitalization , at discharge and during follow-up . Results : Among 105 patients ( mean age 63 ± 12 years ; 66 % men ) , impaired ASA responsiveness at baseline as assessed by aggregometry was associated with increased stroke severity at baseline , unfavourable clinical course , and poor functional outcome during follow-up ( p < 0.05 for all ) . Age-adjusted odds ratios in non-responders compared to good responders were 9.8 for severe stroke on admission ( 95 % CI 2.8–34.9 ) , 3.1 for lack of early clinical improvement ( 95 % CI 1.1–8.8 ) and 8.6 for poor functional outcome during follow-up ( 95 % CI 2.4–30.4 ) . Less robust trends were observed with the Impact-R. Conclusions : Impaired responsiveness to ASA in acute brain ischaemia is common and is associated with worse neurological deficits at stroke onset , early clinical deterioration and poorer functional outcome . The clinical significance of these findings requires further evaluation in larger longitudinal studies
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 .