<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_1905-7415.0906.447_s_001_w2aab3b7b3b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Whether patients with coronary heart disease (CHD) and resistance to aspirin found by in vitro tests are at a greater risk of major adverse cardiovascular events (MACEs) is controversial.</p></sec><sec id="j_1905-7415.0906.447_s_002_w2aab3b7b3b1b6b1aab1c16b2Aa"><h3>Objective</h3><p>To identify any association between resistance to aspirin found by in vitro tests and MACEs in patients with unstable angina pectoris (UAP).</p></sec><sec id="j_1905-7415.0906.447_s_003_w2aab3b7b3b1b6b1aab1c16b3Aa"><h3>Methods</h3><p>Previously we demonstrated that 38 of 104 patients admitted to hospital with UAP showed resistance to aspirin using whole blood aggregometry (WBA). In the present study, the same cohort was observed during a 6-month follow-up. The primary end points were MACEs, including cardiovascular death, nonfatal myocardial infarction, revascularization, stroke/transient ischemic attack, or worsening UAP that required the patient to be readmitted to hospital.</p></sec><sec id="j_1905-7415.0906.447_s_004_w2aab3b7b3b1b6b1aab1c16b4Aa"><h3>Results</h3><p>During the course of 6 months, only 1 patient in the aspirin-sensitive group was lost in follow-up, and MACEs occurred in 24 patients. Patients with resistance to aspirin found by WBA did not apparently have a higher risk of MACEs compared with patients who were aspirin-sensitive (29% vs 20%, P > 0.05). Cox regression analysis showed that resistance to aspirin found by WBA appeared to have no significant correlation with 6-month clinical outcome (HR 1.56, 95% CI 0.70-3.48, P > 0.05).</p></sec><sec id="j_1905-7415.0906.447_s_005_w2aab3b7b3b1b6b1aab1c16b5Aa"><h3>Conclusion</h3><p>Aspirin resistance, as defined by WBA, was not associated with an increased risk of MACEs in patients with UAP in a 6-month follow-up. Clarification of the clinical significance of aspirin responsiveness detected by platelet function tests requires further investigation in larger longitudinal studies.</p></sec></abstract>

BackgroundWhether patients with coronary heart disease (CHD) and resistance to aspirin found by in vitro tests are at a greater risk of major adverse cardiovascular events (MACEs) is controversial.ObjectiveTo identify any association between resistance to aspirin found by in vitro tests and MACEs in patients with unstable angina pectoris (UAP).MethodsPreviously we demonstrated that 38 of 104 patients admitted to hospital with UAP showed resistance to aspirin using whole blood aggregometry (WBA). In the present study, the same cohort was observed during a 6-month follow-up. The primary end points were MACEs, including cardiovascular death, nonfatal myocardial infarction, revascularization, stroke/transient ischemic attack, or worsening UAP that required the patient to be readmitted to hospital.ResultsDuring the course of 6 months, only 1 patient in the aspirin-sensitive group was lost in follow-up, and MACEs occurred in 24 patients. Patients with resistance to aspirin found by WBA did not apparently have a higher risk of MACEs compared with patients who were aspirin-sensitive (29% vs 20%, P > 0.05). Cox regression analysis showed that resistance to aspirin found by WBA appeared to have no significant correlation with 6-month clinical outcome (HR 1.56, 95% CI 0.70-3.48, P > 0.05).ConclusionAspirin resistance, as defined by WBA, was not associated with an increased risk of MACEs in patients with UAP in a 6-month follow-up. Clarification of the clinical significance of aspirin responsiveness detected by platelet function tests requires further investigation in larger longitudinal studies.

Aspirin responsiveness and 6-month clinical outcome observed in a cohort study of patients with unstable angina pectoris

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundWhether patients with coronary heart disease (CHD) and resistance to aspirin found by in vitro tests are at a greater risk of major adverse...

	Total (n = 103)	Major adverse cardiovascular events		P
	Total (n = 103)			P
		Yes(n = 24)	No(n = 79)
Age (y)	64.7 ±9.4	67.3 ± 8.3	63.9 ± 9.6	0.12
Male (%)	57 (55)	14 (58)	43 (54)	0.74
Body mass index (kg/m²)	23.1 ±3.56	24.0±3.98	22.8 ±3.40	0.16
A trial fibrillation (%)	20 (19)	5 (21)	15 (19)	0.84
Smoker (%)	22 (21)	3 (13)	19 (24)	0.23
Hypertension (%)	62 (60)	16 (67)	46 (58)	0.46
Diabetes P < 0.05 (%)	14 (14)	7 (29)	7 (9)	0.011
Hyperlipidemia (%)	12 (12)	1 (4)	11 (14)	0.19
Cerebrovascular disease P < 0.05 (%)	17 (17)	8 (33)	9 (11)	0.011
Impedance values (Ω)	8.3 ±4.46	9.1 ±4.33	8.6±4.50	0.34
Aspirin resistance (%)	38 (37)	11 (46)	27 (34)	0.30

	Hazard Ratio	95% CI	P
Bivariate analysis
Age	1.04	0.99-1.09	0.13
Male	0.94	0.42-2.12	0.89
Body mass index	1.10	0.97-1.24	0.14
Atrial fibrillation	1.13	0.42-3.02	0.81
Smoker	0.51	0.15-1.71	0.28
Hypertension	1.40	0.60–3.27	0.44
Diabetes	3.32	1.37–8.02	0.008 P < 0.05
Hyperlipidemia	0.29	0.04–2.17	0.23
Cerebrovascular disease	3.10	1.32-7.26	0.009 P < 0.05
Impedance values	1.05	0.96–1.15	0.28
Aspirin resistance	1.56	0.70–3.48	0.28
Multivariate analysis
Diabetes	2.61	1.04–6.58	0.04 P < 0.05
Cerebrovascular disease	2.48	1.02–6.05	0.046 P < 0.05

Aspirin responsiveness and 6-month clinical outcome observed in a cohort study of patients with unstable angina pectoris

Article Category: Original article

Published Online: Jan 31, 2017

Page range: 751 - 759

DOI: https://doi.org/10.5372/1905-7415.0906.447

Keywords
Aggregometry, antiplatelet, aspirin responsiveness, major adverse cardiovascular events, unstable angina pectoris

© 2015 Jiabei Li, Yanqi Zhang, Juan Wang, Dehui Qian, Hui Guo, Mingbao Song, Xiaojing Wu, Jun Jin, Junfu Huang, Lan Huang

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Baseline clinical characteristics of the cohort according to the occurrence of major adverse cardiovascular events

Cox regression analysis: hazard ratios of major adverse cardiovascular events according to clinical characteristics, platelet aggregation function, and the status of aspirin responsiveness

Aspirin responsiveness and 6-month clinical outcome observed in a cohort study of patients with unstable angina pectoris

Article Category: Original article

Published Online: Jan 31, 2017

Page range: 751 - 759

DOI: https://doi.org/10.5372/1905-7415.0906.447

KeywordsAggregometry, antiplatelet, aspirin responsiveness, major adverse cardiovascular events, unstable angina pectoris

© 2015 Jiabei Li, Yanqi Zhang, Juan Wang, Dehui Qian, Hui Guo, Mingbao Song, Xiaojing Wu, Jun Jin, Junfu Huang, Lan Huang

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Baseline clinical characteristics of the cohort according to the occurrence of major adverse cardiovascular events

Cox regression analysis: hazard ratios of major adverse cardiovascular events according to clinical characteristics, platelet aggregation function, and the status of aspirin responsiveness

Keywords
Aggregometry, antiplatelet, aspirin responsiveness, major adverse cardiovascular events, unstable angina pectoris