1. Screening for aspirin resistance in stable coronary artery patients by three different tests.
- Author
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Chakroun T, Addad F, Abderazek F, Ben-Farhat M, Hamdi S, Gamra H, Hassine M, Ben-Hamda K, Samama MM, and Elalamy I
- Subjects
- Adult, Aged, Aged, 80 and over, Bleeding Time, Coronary Artery Disease urine, Drug Evaluation, Preclinical methods, Drug Resistance, Female, Humans, Male, Middle Aged, Thromboembolism blood, Thromboembolism prevention & control, Thromboembolism urine, Thromboxane B2 analogs & derivatives, Thromboxane B2 urine, Aspirin pharmacology, Blood Platelets drug effects, Coronary Artery Disease blood, Coronary Artery Disease drug therapy, Platelet Aggregation Inhibitors pharmacology, Platelet Function Tests methods
- Abstract
Background: Aspirin (ASA) failure to inhibit in vitro platelet function had been termed ASA resistance. The prevalence of this phenomenon as measured with different platelet function tests varies widely among studies., Objectives: In this study, we propose to determine the prevalence of ASA non-responsiveness in stable coronary artery patients using three different tests., Patients and Methods: One hundred ninety-one patients with a stable coronary artery disease and receiving secondary ASA prophylaxis (250 mg/day) were tested. For each patient the ASA-induced platelet inhibition was determined using three different tests: Ivy Bleeding time (BT), collagen/epinephrine closure time (CEPI-CT; PFA-100, Dade-Behring) and urinary 11-dehydrothromboxane B2 (uTxB2) excretion level. The agreement between these tests was evaluated by kappa statistics test., Results: The prevalence of biological ASA resistance was 15.7% (n=30), 20.4% (n=39) and 24.6% (n=47) by BT, PFA-100 and UTxB2, respectively. Only fourteen patients (7.3%) were non-responders for two tests: 6 (3.1%) BT/ PFA-100; 1 (0.5%) BT/UTxB2; 7 (3.7%) PFA-100/UTxB2). A poor agreement was found between these three methods and only 3 patients were resistant with all the tests (1.6%)., Conclusion: The lack of agreement supposed that different types of aspirin resistance exist. Thus, combination of two tests or more could be a primary solution for a better identification of ASA resistant patients. This hypothesis must be confirmed by a large-scale randomized study with clinically well-defined endpoints.
- Published
- 2007
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