Aspirin I.V. Loading during Elective Percutaneous Coronary Intervention

Area of Science:

• Cardiology
• Pharmacology
• Clinical Trials

Background:

• Percutaneous coronary interventions (PCI) often involve additional acetylsalicylic acid (ASA) loading doses despite ongoing oral ASA therapy.
• The clinical impact of this practice on platelet reactivity and patient outcomes remains unclear.

Purpose of the Study:

• To investigate high on-treatment platelet reactivity (HTPR) to aspirin in patients undergoing elective PCI.
• To compare platelet reactivity and clinical events between patients receiving a peri-procedural ASA loading dose versus those not receiving it.

Main Methods:

• A pilot study involving 100 patients on chronic low-dose ASA medication undergoing elective PCI.
• Platelet reactivity was assessed using light-transmission aggregometry, measuring arachidonic acid-induced maximum aggregation (MoA).
• Patients were divided into groups with and without an additional intravenous ASA loading dose (500 mg).

Main Results:

• The rate of HTPR (defined as MoA >20%) was similar between the loading dose and control groups (6% vs. 16%).
• No significant differences in in-hospital major adverse cerebro- and cardiovascular events (MACCEs) were observed between the groups.
• Thrombolysis in Myocardial Infarction (TIMI) minimal bleeding events were numerically higher in the control group (without ASA loading).

Conclusions:

• Peri-procedural ASA loading did not effectively reduce HTPR in patients on chronic low-dose ASA undergoing PCI.
• The additional ASA loading dose did not increase in-hospital MACCEs or bleeding complications in this pilot study.