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

Authors	MRDOVIC Igor COLIC Mirko SAVIC Lydija KRLJANAC Gordana KRUŽLIAK Peter LASICA Ratko ASANIN Milika STANKOVIC Sanja MARINKOVIC Jelena
Year of publication	2016
Type	Article in Periodical
Magazine / Source	CARDIOVASCULAR DRUGS AND THERAPY
MU Faculty or unit	Faculty of Medicine
Citation
Doi	http://dx.doi.org/10.1007/s10557-016-6643-8
Keywords	Aspirin resistance; Primary PCI; Clinical outcome
Description	Aims The objective of the present substudy was to examine whether aspirin poor/high responsiveness (APR/AHR) is associated with increased rates of major adverse cardiovascular events (MACE) and serious bleeding after primary percutaneous coronary intervention (PPCI). Methods We analyzed 961 consecutive ST-elevation acute myocardial infarction patients who underwent PPCI between February 2008 and June 2011. Multiplate analyser (Dynabite, Munich, Germany) was used for the assessment of platelet reactivity. APR/AHR were defined as the upper/lower quintiles of ASPI values, determined 24 h after aspirin loading. APR patients were tailored using 300 mg maintenance dose for 30 days. The co-primary end points at 30 days were: MACE (death, non-fatal infarction, ischemia-driven target vessel revascularization and ischemic stroke) and serious bleeding according to the BARC classification. Results One hundred and 90 patients were classified as APR, and 193 patients as AHR. At admission, compared with aspirin sensitive patients (ASP), patients with APR had more frequently diabetes, anterior infarction and heart failure, while AHR patients had reduced values of creatine kinase, leukocytes, heart rate and systolic blood pressure. Compared with ASP, the rates of 30-day primary end points did not differ neither in APR group including tailored patients (MACE, adjusted OR 1.02, 95% CI 0.47-2.17; serious bleeding, adjusted OR 1.92, 95% CI 0.79-4.63), nor in patients with AHR (MACE, adjusted OR 1.58, 95% CI 0.71-5.51; serious bleeding, adjusted OR 0.69, 95% CI 0.22-2.12). Conclusions The majority of APR patients were suitable for tailoring. Neither APR including tailored patients nor AHR were associated with adverse 30-day efficacy or safety clinical outcomes.