Journal
JOURNAL OF THE AMERICAN HEART ASSOCIATION
Volume 6, Issue 8, Pages -Publisher
WILEY
DOI: 10.1161/JAHA.117.006050
Keywords
antiplatelet drug resistance; aspirin; coronary artery disease; prognosis
Categories
Funding
- Danish Agency for Science Technology and Innovation [2101-05-0052]
- Novo-Nordic Foundation [NNF14OC0008817]
- Faculty of Health Sciences, Aarhus University
- Denmark The Danish Heart Foundation
- A.P. Moller Foundation
- Department of Clinical Medicine, Aarhus University
- Eva and Henry Fraenkel Foundation
- Aase and Ejnar Danielsen Foundation
- Korning Foundation
- Sophus Jacobsen and Spouse Astrid Jacobsen Foundation
- Physician's assurance association anno
- Novo Nordisk Fonden [NNF14OC0008817] Funding Source: researchfish
Ask authors/readers for more resources
Background-Increased platelet aggregation during antiplatelet therapy may predict cardiovascular events in patients with coronary artery disease. The majority of these patients receive aspirin monotherapy. We aimed to investigate whether high platelet-aggregation levels predict cardiovascular events in stable coronary artery disease patients treated with aspirin. Methods and Results-We included 900 stable coronary artery disease patients with either previous myocardial infarction, type 2 diabetes mellitus, or both. All patients received single antithrombotic therapy with 75 mg aspirin daily. Platelet aggregation was evaluated 1 hour after aspirin intake using the VerifyNow Aspirin Assay (Accriva Diagnostics) and Multiplate Analyzer (Roche; agonists: arachidonic acid and collagen). Adherence to aspirin was confirmed by serum thromboxane B-2. The primary end point was the composite of nonfatal myocardial infarction, ischemic stroke, and cardiovascular death. At 3-year follow-up, 78 primary end points were registered. The primary end point did not occur more frequently in patients with high platelet-aggregation levels (first versus fourth quartile) assessed by VerifyNow (hazard ratio: 0.5 [95% CI, 0.3-1.1], P=0.08) or Multiplate using arachidonic acid (hazard ratio: 1.0 [95% CI, 0.5-2.1], P=0.92) or collagen (hazard ratio: 1.4 [95% CI, 0.7-2.8], P=0.38). Similar results were found for the composite secondary end point (nonfatal myocardial infarction, ischemic stroke, stent thrombosis, and all-cause death) and the single end points. Thromboxane B-2 levels did not predict any end points. Renal insufficiency was the only clinical risk factor predicting the primary and secondary end points. Conclusions-This study is the largest to investigate platelet aggregation in stable coronary artery disease patients receiving aspirin as single antithrombotic therapy. We found that high platelet-aggregation levels did not predict cardiovascular events.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available