Prevalence of persistent platelet reactivity despite use of aspirin: A systematic review

被引:239
作者
Hovens, Marcel M. C.
Snoep, Jaapjan D.
Eikenboom, Jeroen C. J.
van der Bom, Johanna G.
Mertens, Bart J. A.
Huisman, Menno V.
机构
[1] Leiden Univ, Med Ctr, Dept Gen Internal Med & Endocrinol, NL-2300 RC Leiden, Netherlands
[2] Leiden Univ, Med Ctr, Dept Hematol, NL-2300 RC Leiden, Netherlands
[3] Leiden Univ, Med Ctr, Dept Clin Epidemiol, NL-2300 RC Leiden, Netherlands
[4] Leiden Univ, Med Ctr, Dept Med Stat, NL-2300 RC Leiden, Netherlands
关键词
D O I
10.1016/j.ahj.2006.10.040
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The absolute risk of recurrences among patients using aspirin for prevention of cardiovascular events remains high. Persistent platelet reactivity despite aspirin therapy might explain this in part. Reported prevalences of this so-called aspirin resistance vary widely, between 0% and 57%. Objectives The aim of the study was to systematically review all available evidence on prevalence of aspirin resistance and to study determinants of reported prevalence. Methods Using a predefined search strategy, we searched electronic databases MEDLINE, EMBASE, CENTRAL, and Web of Science. To be included in our analysis, articles had to contain a laboratory definition of aspirin resistance, use aspirin as secondary prevention, and report associated prevalence. Results We included 34 full-text articles and 8 meeting abstracts. The mean prevalence of aspirin resistance was 24% (95% Cl 20%-28%). After adjustment for differences in definition, used dosage, and population, a statistically significant higher prevalence was found in studies with aspirin dosage <= 100 mg compared with >= 300 mg (36% [95% Cl 28%-43%] vs 19% [95% Cl 11%-26%], P < .0001). Studies measuring platelet aggregation using light aggregometry with arachidonic acid as an agonist had a pooled unadjusted prevalence of 6% (95% Cl 0%-12%). In studies using point-of-care platelet function-analyzing devices, the unadjusted prevalence was significantly higher, at 26% (95% Cl 21%-31%). Conclusions Prevalences widely differ between studies reporting on aspirin resistance. Both aspirin dosage and the method of defining aspirin resistance strongly influence estimated prevalence, which explains found heterogeneity among studies. On average, it appears that about 1 in 4 individuals may express biochemically defined aspirin resistance.
引用
收藏
页码:175 / 181
页数:7
相关论文
共 67 条
[1]   Effect of increasing doses of aspirin on platelet function as measured by PFA-100 in patients with diabetes [J].
Abaci, A ;
Yilmaz, Y ;
Caliskan, M ;
Bayram, F ;
Cetin, M ;
Unal, A ;
Cetin, S .
THROMBOSIS RESEARCH, 2005, 116 (06) :465-470
[2]   Antiplatelet effect of aspirin in patients with cerebrovascular disease [J].
Alberts, MJ ;
Bergman, DL ;
Molner, E ;
Jovanovic, BD ;
Ushiwata, I ;
Teruya, J .
STROKE, 2004, 35 (01) :175-178
[3]   Aspirin non-responsiveness as measured by PFA-100 in patients with coronary artery disease [J].
Andersen, K ;
Hurlen, M ;
Arnesen, H ;
Seljeflot, I .
THROMBOSIS RESEARCH, 2002, 108 (01) :37-42
[4]  
Baigent C, 2002, BMJ-BRIT MED J, V324, P71, DOI 10.1136/bmj.324.7329.71
[5]  
Berrouschot J, 2000, STROKE, V31, P2797
[6]  
Böhnig D, 2005, METHOD INFORM MED, V44, P127
[7]   Resistance to aspirin in increased by ST-elevation myocardial infarction and correlates with adenosine diphosphate levels [J].
Borna C. ;
Lazarowski E. ;
van Heusden C. ;
Öhlin H. ;
Erlinge D. .
Thrombosis Journal, 3 (1)
[8]   Vascular biology of thrombosis - Platelet-vessel wall interactions and aspirin effects [J].
Catella-Lawson, F .
NEUROLOGY, 2001, 57 (05) :S5-S7
[9]   In vitro aspirin resistance detected by PFA-100™ closure time:: pivotal role of plasma von Willebrand factor [J].
Chakroun, T ;
Gerotziafas, G ;
Robert, F ;
Lecrubier, C ;
Samama, MM ;
Hatmi, M ;
Elalamy, I .
BRITISH JOURNAL OF HAEMATOLOGY, 2004, 124 (01) :80-85
[10]   Relation of aspirin resistance to coronary flow reserve in patients undergoing elective percutaneous coronary intervention [J].
Chen, WH ;
Lee, PY ;
Ng, W ;
Kwok, JYY ;
Cheng, X ;
Lee, SWL ;
Tse, HF ;
Lau, CP .
AMERICAN JOURNAL OF CARDIOLOGY, 2005, 96 (06) :760-763