CORRELATION OF CLINICAL AND LABORATORY ASPIRIN RESISTANCE: A PILOT STUDY

PRASHANT C K,SUDHA,MURALIDHAR, LAXMINARAYANA,ANNAMMA KURIEN,ASHWIN KAMATH

Abstract


Aspirin resistance may be biochemical or clinical. Data related to the presence of aspirin
resistance in the Indian population is scarce. We conducted a cross sectional study to
address the issue of clinical aspirin non responsiveness and to assess the association
between inhibition of platelet aggregation, clinical risk factors and occurrence of vascular
events. We studied platelet aggregation by optical aggregometry in 20 patients on aspirin.
No patient was found to be aspirin-resistant on the basis of previously defined criteria.
This led us to relook at the current cut offs for resistance, and an analysis of 60 normal
patients showed lower cut off values suggesting ethnic variability. The data was
reanalyzed using these cutoffs. An association between poor clinical aspirin response,
older age, male sex, smoking and dyslipidemia was found, suggesting a trend, though not
significant. 25% of patients had vascular events on aspirin suggesting clinical aspirin
resistance. A lower cut off value for aspirin resistance in normal Indians may be needed
to detect true prevalence of this entity. In patients with multiple atherothrombotic risk
factors lab detection of resistance may be useful in identifying patients with high risk for
recurrent vascular events. This may help to modify antiplatelet therapy to prevent
vascular events.


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