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[Acetylsalicylic acid non-responders after ischemic insult in geriatric patients]

M Nosul1, G F Kolb

  • 1Helios Klinikum Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland, matylda.nosul@helios-kliniken.de.

Zeitschrift Fur Gerontologie Und Geriatrie
|November 26, 2013
PubMed

Insights

Aspirin (acetylsalicylic acid) is used for secondary prevention of cardiovascular and cerebral ischemic events. This study found that nearly 20% of patients taking 100 mg daily aspirin showed inadequate platelet inhibition, suggesting potential risks.

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • Cardiovascular and cerebral ischemic risk involves thromboembolic events.
  • Acetylsalicylic acid (ASA) is the standard secondary prophylaxis, typically at 100 mg daily.
  • Platelet aggregation efficacy is not routinely monitored in patients on ASA.

Purpose of the Study:

  • To assess the efficacy of 100 mg daily aspirin in inhibiting platelet aggregation in stroke patients.
  • To identify the proportion of patients who are non-responders to standard aspirin dosage.

Main Methods:

  • Examined 71 patients admitted to a stroke unit for stroke or recurrence.
  • Assessed platelet aggregation using a Platelet Function Analyser (PFA 100).
  • Classified patients as responders or non-responders based on closure time in the collagen/epinephrine cell.

Main Results:

  • 53 patients (73%) had a primary ischemic insult, 18 (25.4%) had stroke recurrence.
  • 14 patients (19.7%) were identified as non-responders to 100 mg daily aspirin.
  • Non-response was defined by prolonged closure time outside the normal range (85-165 s).

Conclusions:

  • A significant percentage of patients exhibit inadequate platelet inhibition on standard aspirin therapy.
  • The clinical benefit of secondary prophylaxis versus enhanced platelet inhibition requires further investigation.
  • Individualized monitoring of aspirin's antiplatelet effect may be warranted.
Abstract

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