Aspirin Response Predicts Outcome After Stent Surgery

MedicalResearch.com Interview with:
Katharina Mayer MD
Deutsches Herzzentrum München,
Technische Universität München,
Munich, Germany

Medical Research: What are the main findings of the study?

Dr. Mayer: Patients whose platelets do not respond well to aspirin carry a higher risk of death or stent thrombosis. Platelet response to aspirin is an independent predictor of ischemic events in patients undergoing percutaneous coronary interventions (PCI).

Medical Research: Were any of the findings unexpected?

Dr. Mayer: Inhibition of platelet aggregation is an important therapeutic goal of the drugs used for the prevention of stent thrombosis. Although it is intuitive to expect less favorable outcomes in patients with suboptimal inhibition of platelet aggregation after aspirin, a large registry was not able to show previously an association between platelet response to aspirin and clinical outcomes after PCI. Apparently, the type of test used for assessing platelet function after aspirin plays a major role in its ability to predict outcomes. The assessment method used in our study, the point-of-care assay Multiplate analyzer, enabled the identification of the predictive role of platelet response to aspirin.

Medical Research: What should clinicians and patients take away from your report?

Dr. Mayer:   Our study adds to the multiple sources of evidence showing that the platelet response to drugs aiming at the inhibition of platelet aggregation such as aspirin and clopidogrel varies from patient to patient and that this variability correlates with clinical outcomes of patients undergoing a PCI procedure. Tests as that used in our study can easily be integrated in clinical practice to add prognostic information on top of that already provided by other biomarkers.

 

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Mayer:

  • First, studies are needed to evaluate whether platelet response is dependent on the aspirin dose used.
  • Second, despite the failure of a few studies in the past to use platelet function information for guiding antiplatelet therapy, I am sure that this kind of studies will continue to attract a lot of interest in the future.

Citation:

Mayer K, Bernlochner I, Braun S, et al. Aspirin Treatment and Outcomes After Percutaneous Coronary Intervention: Results of the ISAR-ASPI Registry. J Am Coll Cardiol. 2014;64(9):863-871. doi:10.1016/j.jacc.2014.05.049.

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