Journal of Thrombosis and Thrombolysis

, Volume 22, Issue 2, pp 103–110

The role of aspirin resistance on outcome in patients with acute coronary syndrome and the effect of clopidogrel therapy in the prevention of major cardiovascular events

Authors

    • Istanbul Faculty of Medicine, Department of CardiologyIstanbul University
  • Huseyin Oflaz
    • Istanbul Faculty of Medicine, Department of CardiologyIstanbul University
  • Aytac Oncul
    • Istanbul Faculty of Medicine, Department of CardiologyIstanbul University
  • Berrin Umman
    • Istanbul Faculty of Medicine, Department of CardiologyIstanbul University
  • Fehmi Mercanoglu
    • Istanbul Faculty of Medicine, Department of CardiologyIstanbul University
  • Mustafa Ozcan
    • Istanbul Faculty of Medicine, Department of CardiologyIstanbul University
  • Mehmet Meric
    • Istanbul Faculty of Medicine, Department of CardiologyIstanbul University
  • Yilmaz Nisanci
    • Istanbul Faculty of Medicine, Department of CardiologyIstanbul University
Clinical Trials and Thromboepidemiology

DOI: 10.1007/s11239-006-8952-4

Cite this article as:
Pamukcu, B., Oflaz, H., Oncul, A. et al. J Thromb Thrombolysis (2006) 22: 103. doi:10.1007/s11239-006-8952-4
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Abstract

Background: Aspirin resistance may increase up to more then threefold the risk of major cardiovascular events (MACE) in patients with stable coronary artery disease.

Aim:The aim of our study was to determine; the prevalence of aspirin resistance in patients with acute coronary syndromes, the role of aspirin resistance on outcome in the follow-up and the effect of clopidogrel therapy in the prevention of MACE in aspirin resistant subjects.

Material and methods: We detected the prevelance of aspirin resistance in 105 patients with acute coronary syndrome. Platelet functions were analyzed in Platelet Function Analyzer (PFA)-100 (Dade Behring, Germany) with collagen and/or epinephrine (Col/Epi) and collagen and/or ADP (Col/ADP) cartridges. Primary end points of the study were myocardial infarction, unstable angina, cardiac death.

Results: 19% (n = 20) of patients were aspirin resistant by PFA-100. In the follow-up, MACE occured in 9 patients (45%) with aspirin resistance and in 10 patients (11.7%) with aspirin sensitive platelet aggregation (p = 0.001). Multivariate analysis showed that aspirin resistance was an independant predictor of MACE. The prevalence of MACE in patients who were on clopidogrel treatment for 12 months were lower compared to those who were on a clopidogrel treatment for the first six months (p = 0.040).

Conclusions: We determined that the MACE risk in patients with acute coronary syndromes having detected aspirin resistance, was higher at statistically significant levels compared to patients having aspirin sensitive platelet aggregation. Our results showed that aspirin resistance, was an independant predictor of MACE in patients with acute coronary syndrome.

Keywords

Aspirin resistanceAcute coronary syndromeClopidogrelMajor cardiovascular events
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© Springer Science + Business Media, LLC 2006