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
© 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.
Background
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.
Objective
To identify any association between resistance to aspirin found by in vitro tests and MACEs in patients with unstable angina pectoris (UAP).
Methods
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.
Results
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).
Conclusion
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.