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Response variability to aspirin as assessed by the platelet function analyzer (PFA)-100. A systematic review
Marilena Crescente1, Augusto Di Castelnuovo, Licia Iacoviello
1Research Laboratories, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Largo Gemelli 1, 86100 Campobasso, Italy.
Thrombosis and Haemostasis
|January 25, 2008
Summary
Approximately 27% of patients are non-responders to aspirin, as measured by the PFA-100 test. This aspirin resistance is linked to increased vascular event risk and influenced by patient factors and testing methods.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Aspirin is a cornerstone therapy for preventing vascular events.
- Assessing aspirin response is crucial for optimizing treatment.
- The Platelet Function Analyzer-100 (PFA-100) is a point-of-care device used to measure platelet function.
Purpose of the Study:
- To systematically review studies estimating aspirin non-response prevalence using PFA-100 closure time.
- To analyze factors influencing aspirin non-response.
- To investigate the association between aspirin non-response and vascular outcomes.
Main Methods:
- Systematic review of 53 published studies.
- Inclusion of 6,450 subjects across 64 populations.
- Analysis of clinical and methodological factors affecting PFA-100 results.
Main Results:
- Median prevalence of aspirin non-responders was 27%.
- Higher prevalence observed in older patients, those with acute vascular events, and type 2 diabetes.
- Aspirin non-response was associated with increased vascular events (RR 1.63).
- Methodological factors like anticoagulant concentration and timing of assessment influenced results.
Conclusions:
- Around one-quarter of individuals on aspirin may be identified as non-responders by PFA-100.
- Standardization of PFA-100 testing is needed to improve monitoring of platelet function.
- Further research should confirm the association between aspirin non-response and clinical vascular events.
