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The Impact of Aspirin Resistance on the Long‐term Cardiovascular Mortality in Patients with Non‐ST Segment Elevation Acute Coronary Syndromes

Title: The Impact of Aspirin Resistance on the Long‐term Cardiovascular Mortality in Patients with Non‐ST Segment Elevation Acute Coronary Syndromes
Authors: Foussas, Stefanos G.; Zairis, Michael N.; Tsirimpis, Vasilios G.; Makrygiannis, Stamatis S.; Patsourakos, Nikolaos G.; Adamopoulou, Evdokia N.; Mytas, Demetrios Z.; Prekates, Athanasios A.; Perdiou, Anna J.; Tsoukanas, Vasilios K.; Argyrakis, Spyros K.
Source: Clinical Cardiology ; volume 32, issue 3, page 142-147 ; ISSN 0160-9289 1932-8737
Publisher Information: Wiley
Publication Year: 2009
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Background Aspirin resistance has been associated with an adverse long‐term outcome in patients with atherosclerotic coronary artery disease, but more studies are needed. Hypothesis The aim of this study was to investigate the impact of aspirin resistance, assessed by the Platelet Function Analyzer‐100 (PFA‐100) (Dade Behring Inc., Deerfield, Ill., USA) on the long‐term prognosis in patients with non‐ST segment elevation acute coronary syndromes (NSTE‐ACS). Methods A total of 496 consecutive patients were studied. The 1‐y incidence of cardiovascular death was the prespecified study endpoint. The patients were divided, according to the values of PFA‐100 collagen epinephrine closure time (CEPI‐CT) upon presentation, into aspirin sensitives (those with a PFA‐100 CEPI‐CT > 193 sec) and aspirin resistants (those with a PFA‐100 CEPI‐CT ≤ 193 sec). Results Aspirin resistants were younger (p‐value = 0.04), and less frequently hypertensives (p‐value = 0.05) or diabetics (p‐value = 0.04) than aspirin sensitives. By 1 y, the incidence of cardiovascular deaths in the entire cohort was 12.9% (64/496), and aspirin resistants were at significantly higher risk of cardiovascular death (23.1% versus 9.6%; hazard ratio [HR] = 2.6; 95% confidence interval [CI] = 1.6–4.3; p‐value < 0.001), than aspirin sensitives. By multivariate Cox regression analysis, aspirin resistance (a PFA‐100 CEPI‐CT ≤ 193 sec) was among the most potent predictors of the 1‐y incidence of cardiovascular death (HR = 2.8; 95% CI = 1.7–4.6; p‐value < 0.001). Conclusion According to the present data, aspirin resistance, assessed by the PFA‐100, is an independent predictor of long‐term cardiovascular mortality in patients with NSTE‐ACS. Copyright © 2009 Wiley Periodicals, Inc.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1002/clc.20293
Availability: http://dx.doi.org/10.1002/clc.20293; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1002%2Fclc.20293; https://onlinelibrary.wiley.com/doi/pdf/10.1002/clc.20293
Rights: http://onlinelibrary.wiley.com/termsAndConditions#vor
Accession Number: edsbas.BB64593B
Database: BASE