Related Experiment Video

Updated: Mar 26, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

6.1K

Clinical Significance of Laboratory-determined Aspirin Poor Responsiveness After Primary Percutaneous Coronary

Igor Mrdovic1,2, Mirko Čolić3, Lidija Savic4

  • 1University of Belgrade School of Medicine, Belgrade, Serbia. igormrd@gmail.com.

Cardiovascular Drugs and Therapy
|February 5, 2016
PubMed

Insights

Aspirin resistance (APR/AHR) did not increase adverse cardiovascular events or bleeding after primary PCI. Tailoring aspirin dosage for APR patients showed no significant difference in 30-day outcomes.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Aspirin responsiveness varies among patients undergoing primary percutaneous coronary intervention (PPCI).
  • Assessing aspirin poor/high responsiveness (APR/AHR) is crucial for optimizing antiplatelet therapy.
  • Understanding the clinical implications of APR/AHR is essential for patient outcomes post-PPCI.

Purpose of the Study:

  • To investigate the association between aspirin poor/high responsiveness (APR/AHR) and major adverse cardiovascular events (MACE) and serious bleeding.
  • To evaluate the efficacy and safety of tailored aspirin dosing in APR patients after PPCI.

Main Methods:

  • Analysis of 961 ST-elevation acute myocardial infarction patients undergoing PPCI.
  • Platelet reactivity assessed using a Multiplate analyser 24 hours post-aspirin loading.
  • APR/AHR defined by ASPI values; APR patients received tailored 300 mg maintenance dose for 30 days.
  • Co-primary endpoints: 30-day MACE and serious bleeding (BARC classification).

Main Results:

  • 190 patients classified as APR, 193 as AHR.
  • APR patients had higher rates of diabetes, anterior infarction, and heart failure at admission.
  • No significant difference in 30-day MACE or serious bleeding rates for APR (including tailored) or AHR groups compared to aspirin-sensitive patients.

Conclusions:

  • Tailoring aspirin dosage in APR patients is feasible for the majority.
  • Neither APR (including tailored therapy) nor AHR were linked to adverse 30-day clinical outcomes after PPCI.
  • Current aspirin responsiveness assessment may not predict short-term MACE or bleeding risk in this population.
Abstract

Keywords:
Aspirin resistanceClinical outcomePrimary PCI

More Related Videos

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders05:58

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders

Published on: February 3, 2021

4.4K
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

1.0K

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
414
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
439
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
1.5K
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
695
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
1.5K
Drug Toxicity: Risk factors01:24

Drug Toxicity: Risk factors

Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
166