Variabilidad de la respuesta plaquetaria a la aspirina

Translated title of the contribution: Assessing platelet response to aspirin

Sarah L. Fairley, Pascal P. McKeown, Frank Kee, Mary Francis McMullin, Mike Stevenson, Alison R. Muir

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Despite the 25% reduction in major events with aspirin in high-risk patients reported by the Antiplatelet Trialists' Collaboration, a proportion of patients develop recurrent ischaemic events. This has led to the emergence of 'aspirin resistance' with rates between 0.4% and 83% reported. This study assessed variability in baseline platelet function, prevalence of aspirin resistance, and the performance and reproducibility of platelet function testing methods. Materials and methods: A repeated-measures randomised crossover study was performed in healthy individuals aged 18-60 years. After informed consent, patients were randomised to aspirin dose (75 mg or 300 mg) and treatment sequence with testing at baseline and after each four 3-week treatment period via Optical Platelet Aggregation (OPA), PFA-100™, VerifyNow™, and serum and urinary thromboxane (TXB2) levels. Local ethical approval was granted. Statistical analysis was performed using SPSS17. Results: The overall rate of aspirin resistance varied from 2.4% to 63.5% depending on the assay used. Significant inter- and intra-individual variability existed at baseline and on placebo testing between assays. Assay sensitivities ranged from 24.0% (OPA ADP10) to 87.8% (serum TXB2), and specificities from 81.0% (PFA-100™) to 97.4% (serum TXB2). Selection of alternative cut-off values resulted in differing prevalence rates of biochemical aspirin resistance with a trade-off between sensitivity and specificity. Conclusions: Response to aspirin shows marked inter-assay, inter-individual and temporal variability. Testing on multiple occasions using several assays is necessary to reliably diagnose aspirin resistance. Selection of alternative assay cut-off values should be considered when formally assessing aspirin response.

Translated title of the contributionAssessing platelet response to aspirin
Original languageSpanish
Pages (from-to)229-234
Number of pages6
JournalSalud(i)Ciencia
Volume22
Issue number3
Publication statusPublished - 01 Oct 2016

Keywords

  • Antiplatelet therapies
  • Aspirin resistance
  • Platelet function testing
  • Platelet polymorphisms

ASJC Scopus subject areas

  • Medicine(all)

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