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Aspirin “resistance” and risk of cardiovascular morbidity: systematic review and meta-analysis

BMJ, 2008-01, Vol.336 (7637), p.195-198 [Peer Reviewed Journal]

BMJ Publishing Group Ltd 2008 ;Copyright 2008 BMJ Publishing Group Ltd. ;2008 INIST-CNRS ;Copyright: 2008 (c) BMJ Publishing Group Ltd 2008 ;BMJ Publishing Group Ltd 2008 2008 BMJ Publishing Group Ltd ;ISSN: 0959-8138 ;ISSN: 0959-8146 ;EISSN: 1468-5833 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.39430.529549.BE ;PMID: 18202034 ;CODEN: BMJOAE

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Title:
Aspirin “resistance” and risk of cardiovascular morbidity: systematic review and meta-analysis
Author: Krasopoulos, George ; Brister, Stephanie J ; Beattie, W Scott ; Buchanan, Michael R
Subjects: Acute coronary syndrome ; Acute Coronary Syndrome - epidemiology ; Aspirin ; Aspirin - therapeutic use ; Biological and medical sciences ; Blood plasma ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Confidence interval ; Death, Sudden, Cardiac - epidemiology ; Dose response relationship ; Drug resistance ; Drug Resistance - physiology ; General aspects ; Health outcomes ; Health risk assessment ; Humans ; Medical sciences ; Miscellaneous ; Morbidity ; Odds Ratio ; Platelet aggregation inhibitors ; Platelet Aggregation Inhibitors - therapeutic use ; Platelets ; Prevalence ; Prognosis ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Risk Factors ; Side effects ; Stroke - epidemiology ; Strokes ; Treatment Failure
Is Part Of: BMJ, 2008-01, Vol.336 (7637), p.195-198
Description: Objective To determine if there is a relation between aspirin “resistance” and clinical outcomes in patients with cardiovascular disease.Design Systematic review and meta-analysis.Data source Electronic literature search without language restrictions of four databases and hand search of bibliographies for other relevant articles.Review methods Inclusion criteria included a test for platelet responsiveness and clinical outcomes. Aspirin resistance was assessed, using a variety of platelet function assays.Results 20 studies totalling 2930 patients with cardiovascular disease were identified. Most studies used aspirin regimens, ranging from 75-325 mg daily, and six studies included adjunct antiplatelet therapy. Compliance was confirmed directly in 14 studies and by telephone or interviews in three. Information was insufficient to assess compliance in three studies. Overall, 810 patients (28%) were classified as aspirin resistant. A cardiovascular related event occurred in 41% of patients (odds ratio 3.85, 95% confidence interval 3.08 to 4.80), death in 5.7% (5.99, 2.28 to 15.72), and an acute coronary syndrome in 39.4% (4.06, 2.96 to 5.56). Aspirin resistant patients did not benefit from other antiplatelet treatment.Conclusion Patients who are resistant to aspirin are at a greater risk of clinically important cardiovascular morbidity long term than patients who are sensitive to aspirin.
Publisher: London: British Medical Journal Publishing Group
Language: English
Identifier: ISSN: 0959-8138
ISSN: 0959-8146
EISSN: 1468-5833
EISSN: 1756-1833
DOI: 10.1136/bmj.39430.529549.BE
PMID: 18202034
CODEN: BMJOAE
Source: AUTh Library subscriptions: ProQuest Central
MEDLINE
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Aspirin “resistance” and risk of cardiovascular morbidity: systematic review and meta-analysis

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