title: Clinical Significance of Laboratory-determined Aspirin Poor Responsiveness After Primary Percutaneous Coronary Intervention.
abstract: OBJECTIVE
  The objective of the present substudy was to examine whether aspirin poor/high responsiveness (APR/AHR) is associated with increased rates of major adverse cardiovascular events (MACE) and serious bleeding after primary percutaneous coronary intervention (PPCI).
  
  
  METHODS
  We analyzed 961 consecutive ST-elevation acute myocardial infarction patients who underwent PPCI between February 2008 and June 2011. Multiplate analyser (Dynabite, Munich, Germany) was used for the assessment of platelet reactivity. APR/AHR were defined as the upper/lower quintiles of ASPI values, determined 24 h after aspirin loading. APR patients were tailored using 300 mg maintenance dose for 30 days. The co-primary end points at 30 days were: MACE (death, non-fatal infarction, ischemia-driven target vessel revascularization and ischemic stroke) and serious bleeding according to the BARC classification.
  
  
  RESULTS
  One hundred and 90 patients were classified as APR, and 193 patients as AHR. At admission, compared with aspirin sensitive patients (ASP), patients with APR had more frequently diabetes, anterior infarction and heart failure, while AHR patients had reduced values of creatine kinase, leukocytes, heart rate and systolic blood pressure. Compared with ASP, the rates of 30-day primary end points did not differ neither in APR group including tailored patients (MACE, adjusted OR 1.02, 95%CI 0.47-2.17; serious bleeding, adjusted OR 1.92, 95%CI 0.79-4.63), nor in patients with AHR (MACE, adjusted OR 1.58, 95%CI 0.71-5.51; serious bleeding, adjusted OR 0.69, 95%CI 0.22-2.12).
  
  
  CONCLUSIONS
  The majority of APR patients were suitable for tailoring. Neither APR including tailored patients nor AHR were associated with adverse 30-day efficacy or safety clinical outcomes.
authors: University of Belgrade School of Medicine, Belgrade, Serbia. igormrd@gmail.com.|Clinical Center of Serbia, Emergency Hospital & Cardiology Clinic, Coronary Care Unit A, Pasterova 2, Belgrade, 11 000, Serbia. igormrd@gmail.com.
authors: Igor
authors: I
authors: Mrdovic
authors: Institute of Cardiovascular Diseases Dedinje, Belgrade, Serbia.
authors: Mirko
authors: M
authors: Čolić
authors: Clinical Center of Serbia, Emergency Hospital & Cardiology Clinic, Coronary Care Unit A, Pasterova 2, Belgrade, 11 000, Serbia.
authors: Lidija
authors: L
authors: Savic
authors: University of Belgrade School of Medicine, Belgrade, Serbia.|Clinical Center of Serbia, Emergency Hospital & Cardiology Clinic, Coronary Care Unit A, Pasterova 2, Belgrade, 11 000, Serbia.
authors: Gordana
authors: G
authors: Krljanac
authors: 2nd Department of Internal Medicine, Faculty of Medicine, Masaryk University, Pekarska 53, Brno, Czech Republic.
authors: Peter
authors: P
authors: Kruzliak
authors: University of Belgrade School of Medicine, Belgrade, Serbia.|Clinical Center of Serbia, Emergency Hospital & Cardiology Clinic, Coronary Care Unit A, Pasterova 2, Belgrade, 11 000, Serbia.
authors: Ratko
authors: R
authors: Lasica
authors: University of Belgrade School of Medicine, Belgrade, Serbia.|Clinical Center of Serbia, Emergency Hospital & Cardiology Clinic, Coronary Care Unit A, Pasterova 2, Belgrade, 11 000, Serbia.
authors: Milika
authors: M
authors: Asanin
authors: Center for Medical Biochemistry, School of Pharmacy University of Belgrade, Clinical Center of Serbia, Belgrade, Serbia.
authors: Sanja
authors: S
authors: Stanković
authors: University of Belgrade School of Medicine, Belgrade, Serbia.|Institute for Medical Statistics and Informatics, Belgrade, Serbia.
authors: Jelena
authors: J
authors: Marinkovic
mesh_terms: D000368:Aged; D001241:Aspirin / Q000009:adverse effects* / Q000627:therapeutic use*; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D003402:Creatine Kinase / Q000378:metabolism; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006470:Hemorrhage / Q000139:chemically induced / Q000378:metabolism; D006801:Humans; D007962:Leukocytes / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000378:metabolism; D062645:Percutaneous Coronary Intervention / Q000379:methods; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D020521:Stroke / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D003402:Creatine Kinase; D001241:Aspirin
keywords: Aspirin resistance; Clinical outcome; Primary PCI