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Article: Aspirin resistance is associated with a high incidence of myonecrosis after non-urgent percutaneous coronary intervention despite clopidogrel pretreatment

TitleAspirin resistance is associated with a high incidence of myonecrosis after non-urgent percutaneous coronary intervention despite clopidogrel pretreatment
Authors
KeywordsARU
Aspirin reaction unit
CK-MB
Creatine kinase-myocardial band
Non-steroidal anti-inflammatory drugs
NSAID
Odds ratio
OR
PCI
Percutaneous coronary intervention
TnI
Troponin I
Issue Date2004
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jac
Citation
Journal Of The American College Of Cardiology, 2004, v. 43 n. 6, p. 1122-1126 How to Cite?
AbstractObjectives We sought to investigate the effect of aspirin resistance on the incidence of myonecrosis after non-urgent percutaneous coronary intervention (PCI) among patients pretreated with clopidogrel. Background Oral antiplatelet therapy using aspirin and a thienopyridine is the standard of care for preventing thrombotic complications of PCI. The effect of aspirin resistance on the outcomes of patients undergoing PCI is unknown. Methods We used the Ultegra Rapid Platelet Function Assay-ASA (Accumetrics Inc., San Diego, California) to determine aspirin responsiveness of 151 patients scheduled for non-urgent PCI. All patients received a 300-mg loading dose of clopidogrel >12 h before and a 75-mg maintenance dose in the morning of the PCI. The incidence of myonecrosis was measured by creatine kinase-myocardial band (CK-MB) and by troponin I (TnI) elevations after PCI. Results A total of 29 (19.2%) patients were noted to be aspirin-resistant. There was a significantly higher incidence of female subjects in the aspirin-resistant versus aspirin-sensitive groups. The incidence of any CK-MB elevation was 51.7% in aspirin-resistant patients and 24.6% in aspirin-sensitive patients (p = 0.006). Elevation of TnI was observed in 65.5% of aspirin-resistant patients and 38.5% of aspirin-sensitive patients (p = 0.012). Multivariate analysis revealed aspirin resistance (odds ratio [OR] 2.9; 95% confidence interval [CI] 1.2 to 6.9; p = 0.015) and bifurcation lesion (OR 2.8; 95% CI 1.3 to 6.0; p = 0.007) to be independent predictors of CK-MB elevation after PCI. Conclusions Despite adequate pretreatment with clopidogrel, patients with aspirin resistance as measured by a point-of-care assay have an increased risk of myonecrosis following non-urgent PCI. © 2004 by the American College of Cardiology Foundation.
Persistent Identifierhttp://hdl.handle.net/10722/77238
ISSN
2015 Impact Factor: 17.759
2015 SCImago Journal Rankings: 10.097
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChen, WHen_HK
dc.contributor.authorLee, PYen_HK
dc.contributor.authorNg, Wen_HK
dc.contributor.authorTse, HFen_HK
dc.contributor.authorLau, CPen_HK
dc.date.accessioned2010-09-06T07:29:45Z-
dc.date.available2010-09-06T07:29:45Z-
dc.date.issued2004en_HK
dc.identifier.citationJournal Of The American College Of Cardiology, 2004, v. 43 n. 6, p. 1122-1126en_HK
dc.identifier.issn0735-1097en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77238-
dc.description.abstractObjectives We sought to investigate the effect of aspirin resistance on the incidence of myonecrosis after non-urgent percutaneous coronary intervention (PCI) among patients pretreated with clopidogrel. Background Oral antiplatelet therapy using aspirin and a thienopyridine is the standard of care for preventing thrombotic complications of PCI. The effect of aspirin resistance on the outcomes of patients undergoing PCI is unknown. Methods We used the Ultegra Rapid Platelet Function Assay-ASA (Accumetrics Inc., San Diego, California) to determine aspirin responsiveness of 151 patients scheduled for non-urgent PCI. All patients received a 300-mg loading dose of clopidogrel >12 h before and a 75-mg maintenance dose in the morning of the PCI. The incidence of myonecrosis was measured by creatine kinase-myocardial band (CK-MB) and by troponin I (TnI) elevations after PCI. Results A total of 29 (19.2%) patients were noted to be aspirin-resistant. There was a significantly higher incidence of female subjects in the aspirin-resistant versus aspirin-sensitive groups. The incidence of any CK-MB elevation was 51.7% in aspirin-resistant patients and 24.6% in aspirin-sensitive patients (p = 0.006). Elevation of TnI was observed in 65.5% of aspirin-resistant patients and 38.5% of aspirin-sensitive patients (p = 0.012). Multivariate analysis revealed aspirin resistance (odds ratio [OR] 2.9; 95% confidence interval [CI] 1.2 to 6.9; p = 0.015) and bifurcation lesion (OR 2.8; 95% CI 1.3 to 6.0; p = 0.007) to be independent predictors of CK-MB elevation after PCI. Conclusions Despite adequate pretreatment with clopidogrel, patients with aspirin resistance as measured by a point-of-care assay have an increased risk of myonecrosis following non-urgent PCI. © 2004 by the American College of Cardiology Foundation.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jacen_HK
dc.relation.ispartofJournal of the American College of Cardiologyen_HK
dc.rightsJournal of the American College of Cardiology. Copyright © Elsevier Inc.-
dc.subjectARUen_HK
dc.subjectAspirin reaction uniten_HK
dc.subjectCK-MBen_HK
dc.subjectCreatine kinase-myocardial banden_HK
dc.subjectNon-steroidal anti-inflammatory drugsen_HK
dc.subjectNSAIDen_HK
dc.subjectOdds ratioen_HK
dc.subjectORen_HK
dc.subjectPCIen_HK
dc.subjectPercutaneous coronary interventionen_HK
dc.subjectTnIen_HK
dc.subjectTroponin Ien_HK
dc.subject.meshAngioplasty, Transluminal, Percutaneous Coronary-
dc.subject.meshAspirin - administration and dosage-
dc.subject.meshCoronary Artery Disease - therapy-
dc.subject.meshDrug Resistance-
dc.subject.meshMyocardial Infarction - blood-
dc.titleAspirin resistance is associated with a high incidence of myonecrosis after non-urgent percutaneous coronary intervention despite clopidogrel pretreatmenten_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0735-1097&volume=43&issue=6&spage=1122&epage=1126&date=2004&atitle=Aspirin+resistance+is+associated+with+a+high+incidence+of+myonecrosis+after+non-urgent+percutaneous+coronary+intervention+despite+clopidogrel+pretreatment.en_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1016/j.jacc.2003.12.034en_HK
dc.identifier.pmid15028378-
dc.identifier.scopuseid_2-s2.0-1542708471en_HK
dc.identifier.hkuros113923en_HK
dc.identifier.hkuros88010-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-1542708471&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume43en_HK
dc.identifier.issue6en_HK
dc.identifier.spage1122en_HK
dc.identifier.epage1126en_HK
dc.identifier.isiWOS:000220212400032-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChen, WH=7409637978en_HK
dc.identifier.scopusauthoridLee, PY=8933949600en_HK
dc.identifier.scopusauthoridNg, W=7401613562en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK

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