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Article: Low-dose aspirin increases aspirin resistance in patients with coronary artery disease

TitleLow-dose aspirin increases aspirin resistance in patients with coronary artery disease
Authors
Issue Date2005
PublisherExcerpta Medica, Inc. The Journal's web site is located at http://www.elsevier.com/locate/amj
Citation
American Journal Of Medicine, 2005, v. 118 n. 7, p. 723-727 How to Cite?
AbstractPURPOSE: We sought to investigate the association of aspirin dose and aspirin resistance in stable coronary artery disease patients measured by a point-of-care assay. METHODS: We studied 468 consecutive stable coronary artery disease patients in a referral cardiac center who were taking aspirin 80 to 325 mg daily for ≥4 weeks. The VerifyNow Aspirin (Ultegra RPFA-ASA, Accumetrics Inc, San Diego, Calif) was used to determine aspirin responsiveness. An aspirin reaction unit (ARU) ≥550 indicates the absence of aspirin-induced platelet dysfunction, based on correlation with epinephrine-induced light transmission aggregometry. Demographic and clinical data were collected to analyze the predictors of aspirin resistance. RESULTS: Aspirin resistance was noted in 128 (27.4%) patients. Univariate predictors of aspirin resistance include elderly (P = 0.002), women (P <0.001), anemia (P <0.001), renal insufficiency (P = 0.009) and aspirin dose ≤100mg (P = 0.004). Multivariate analysis revealed hemoglobin (odds ratio [OR] 0.6; 95% confidence interval [CI] 0.51 to 0.69; P <0.001) and aspirin dose ≤100 mg (OR 2.23; 95% CI 1.12 to 4.44; P = 0.022) to be independent predictors of aspirin resistance. Daily aspirin dose ≤ 100 mg was associated with increased prevalence of aspirin resistance compared with 150 mg and 300 mg daily (30.2% vs 16.7% vs 0%, P = 0.0062). CONCLUSION: A 100 mg or less daily dose of aspirin, which may have lower side effects, is associated with a higher incidence of aspirin resistance in patients with coronary artery disease. Prospective randomized studies are warranted to elucidate the optimal aspirin dosage for preventing ischemic complications of atherothrombotic disease. © 2005 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/162856
ISSN
2015 Impact Factor: 5.61
2015 SCImago Journal Rankings: 2.023
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLee, PYen_US
dc.contributor.authorChen, WHen_US
dc.contributor.authorNg, Wen_US
dc.contributor.authorCheng, Xen_US
dc.contributor.authorKwok, JYYen_US
dc.contributor.authorTse, HFen_US
dc.contributor.authorLau, CPen_US
dc.date.accessioned2012-09-05T05:24:28Z-
dc.date.available2012-09-05T05:24:28Z-
dc.date.issued2005en_US
dc.identifier.citationAmerican Journal Of Medicine, 2005, v. 118 n. 7, p. 723-727en_US
dc.identifier.issn0002-9343en_US
dc.identifier.urihttp://hdl.handle.net/10722/162856-
dc.description.abstractPURPOSE: We sought to investigate the association of aspirin dose and aspirin resistance in stable coronary artery disease patients measured by a point-of-care assay. METHODS: We studied 468 consecutive stable coronary artery disease patients in a referral cardiac center who were taking aspirin 80 to 325 mg daily for ≥4 weeks. The VerifyNow Aspirin (Ultegra RPFA-ASA, Accumetrics Inc, San Diego, Calif) was used to determine aspirin responsiveness. An aspirin reaction unit (ARU) ≥550 indicates the absence of aspirin-induced platelet dysfunction, based on correlation with epinephrine-induced light transmission aggregometry. Demographic and clinical data were collected to analyze the predictors of aspirin resistance. RESULTS: Aspirin resistance was noted in 128 (27.4%) patients. Univariate predictors of aspirin resistance include elderly (P = 0.002), women (P <0.001), anemia (P <0.001), renal insufficiency (P = 0.009) and aspirin dose ≤100mg (P = 0.004). Multivariate analysis revealed hemoglobin (odds ratio [OR] 0.6; 95% confidence interval [CI] 0.51 to 0.69; P <0.001) and aspirin dose ≤100 mg (OR 2.23; 95% CI 1.12 to 4.44; P = 0.022) to be independent predictors of aspirin resistance. Daily aspirin dose ≤ 100 mg was associated with increased prevalence of aspirin resistance compared with 150 mg and 300 mg daily (30.2% vs 16.7% vs 0%, P = 0.0062). CONCLUSION: A 100 mg or less daily dose of aspirin, which may have lower side effects, is associated with a higher incidence of aspirin resistance in patients with coronary artery disease. Prospective randomized studies are warranted to elucidate the optimal aspirin dosage for preventing ischemic complications of atherothrombotic disease. © 2005 Elsevier Inc. All rights reserved.en_US
dc.languageengen_US
dc.publisherExcerpta Medica, Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjen_US
dc.relation.ispartofAmerican Journal of Medicineen_US
dc.subject.meshAgeden_US
dc.subject.meshAspirin - Administration & Dosage - Therapeutic Useen_US
dc.subject.meshCoronary Disease - Blood - Drug Therapyen_US
dc.subject.meshDose-Response Relationship, Drugen_US
dc.subject.meshDrug Resistanceen_US
dc.subject.meshFemaleen_US
dc.subject.meshHemoglobins - Metabolismen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPlatelet Aggregation - Drug Effectsen_US
dc.subject.meshPlatelet Aggregation Inhibitors - Administration & Dosage - Therapeutic Useen_US
dc.subject.meshRetrospective Studiesen_US
dc.titleLow-dose aspirin increases aspirin resistance in patients with coronary artery diseaseen_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.amjmed.2005.03.041en_US
dc.identifier.pmid15989905-
dc.identifier.scopuseid_2-s2.0-21244446907en_US
dc.identifier.hkuros100821-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-21244446907&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume118en_US
dc.identifier.issue7en_US
dc.identifier.spage723en_US
dc.identifier.epage727en_US
dc.identifier.isiWOS:000230472600009-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLee, PY=8933949600en_US
dc.identifier.scopusauthoridChen, WH=7409637978en_US
dc.identifier.scopusauthoridNg, W=7401613562en_US
dc.identifier.scopusauthoridCheng, X=37044433500en_US
dc.identifier.scopusauthoridKwok, JYY=8933949800en_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US

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