title: Major clinical vascular events and aspirin-resistance status as determined by the PFA-100 method among patients with stable coronary artery disease: a prospective study.
abstract: Aspirin inhibits platelet activation and reduces major vascular events in patients with stable coronary artery disease. The extent of platelet inhibition, denoted as aspirin resistance, however, is not always sufficient. A correlation between aspirin resistance as measured by aggregometry and adverse clinical events has been demonstrated. The point-of-care platelet function analyzer PFA-100 is usually used to detect aspirin resistance, but the relation between PFA-100 results and the vascular prognosis is not assessed. We prospectively enrolled 97 patients with stable coronary artery disease who were on aspirin (160 mg per day since 1 month or longer). Aspirin resistance was measured by the PFA-100 analyzer. Median follow-up was 2.5 years and the primary outcome was the composite of death, myocardial infarction, and ischemic cerebral infarction or acute limb ischemia. In our study, 29 patients (29.9%) showed resistance to aspirin, with a higher percentage of female patients (38 vs. 15%; P=0.01). During the follow-up, aspirin resistance was not associated with an increased risk of death, myocardial infarction, or ischemic vascular event compared with the aspirin-sensitive patients (17 vs. 13%; P>0.60). In this cohort of stable coronary artery disease, patients on aspirin dose of 160 mg per day, the aspirin-resistance status based on the PFA-100 results is not associated with a significant increase in major vascular clinical events.
authors.affiliation: CHU Poitiers, Department of Cardiology, Research Clinical Center, Laboratory of Hematology, Poitiers, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Christiaens
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ragot
authors.forename: Jean
authors.initials: J
authors.lastname: Mergy
authors.forename: Joseph
authors.initials: J
authors.lastname: Allal
authors.forename: Laurent
authors.initials: L
authors.lastname: Macchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000494:pharmacology*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000188:drug therapy*; D004351:Drug Resistance; D005260:Female; D006403:Hematologic Tests / Q000295:instrumentation*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control; D010974:Platelet Aggregation / Q000187:drug effects* / Q000502:physiology; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D019095:Point-of-Care Systems; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin