Aspirin Cessation Before Interventional Procedures: Not Blindly Following Guidelines but Making Test-based Decisions

Area of Science:

• Cardiology
• Pain Medicine
• Pharmacology

Background:

• Guideline inconsistencies exist regarding aspirin discontinuation before interventional procedures.
• Individual platelet function is often overlooked in current recommendations.
• Aspirin resistance prevalence is a significant clinical concern.

Purpose of the Study:

• To assess the necessity of aspirin discontinuation before interventional pain procedures.
• To evaluate the role of individual platelet function in this decision.
• To compare platelet function in aspirin-taking versus non-aspirin-taking patients.

Main Methods:

• A multicenter, cross-sectional study involving 1,111 patients.
• Platelet function measured using closure time with collagen/epinephrine cartridges.
• Patients categorized into aspirin-taking (Group A) and non-aspirin-taking (Group N) groups.

Main Results:

• 56.4% of aspirin-taking patients (Group A) exhibited normal platelet function.
• 43.6% of aspirin-taking patients showed abnormal platelet function.
• 85.8% of non-aspirin-taking patients (Group N) had normal platelet function, while 14.2% showed abnormal function.

Conclusions:

• High prevalence of normal platelet function in aspirin users suggests discontinuation may not always be required.
• Abnormal platelet function can occur in both aspirin users and non-users.
• Individual platelet function testing is crucial for personalized decisions on aspirin use prior to interventional procedures.