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Aspirin resistance in infants with shunt-dependent congenital heart disease

Wonshill Koh1,2, Megan Rodts1, Ashley Nebbia3

  • 1The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Cardiology in the Young
|July 26, 2021
PubMed

Insights

Infants with cyanotic heart disease and low birth weight show higher aspirin resistance. Aspirin resistance combined with thrombotic events significantly increases mortality risk in these infants, necessitating closer monitoring.

Area of Science:

  • Pediatric Cardiology
  • Neonatal Thrombosis
  • Pharmacogenomics

Background:

  • Cyanotic heart disease increases thrombosis risk in infants.
  • Aspirin resistance is a concern in neonates with shunt-dependent physiology.
  • Investigating aspirin resistance and its impact on outcomes is crucial.

Purpose of the Study:

  • To determine the incidence of aspirin resistance in infants with shunt-dependent physiology.
  • To explore the relationship between aspirin resistance, thrombotic events, and mortality.
  • To identify factors associated with aspirin resistance in this population.

Main Methods:

  • VerifyNow™ testing for aspirin resistance in infants post-shunt palliation.
  • Collection of in-hospital thrombotic events and mortality data.
  • Statistical analysis to assess the impact of aspirin resistance on outcomes.

Main Results:

  • 12% of infants exhibited aspirin resistance, associated with lower birth weight (<2500g).
  • Initial aspirin resistance was overcome with dose adjustments.
  • No significant difference in thrombotic events between groups.
  • Aspirin resistance and thrombotic events together significantly increased in-hospital mortality.

Conclusions:

  • Low birth weight is a predictor of aspirin resistance in infants with cyanotic heart disease.
  • Inadequate initial aspirin dosing is a likely cause of resistance.
  • Combined aspirin resistance and thrombotic events indicate a high-risk group requiring vigilant monitoring.
Abstract

Keywords:
Thrombosisaspirin resistancecongenital heart diseaseshunt dependent

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