Aspirin resistance: Prevalence and clinical outcome in Egypt

• Main Authors: Ahmed Salah, Mohammed El-Desuky, Amal Rizk, Amr El-Hadidy
• Format: Article
• Language: English
• Published: Wolters Kluwer 2015-04-01
• Series: Egyptian Journal of Critical Care Medicine
• Subjects: Aspirin resistance; Coronary artery disease; Clinical outcome
• Online Access: http://www.sciencedirect.com/science/article/pii/S2090730314000309

Introduction: The antiplatelet drug aspirin is considered as a cornerstone in medical treatment of patients with CV or cerebrovascular diseases. Despite its use, a significant number of patients had recurrent adverse ischemic events. Inter-individual variability of platelet aggregation in response to aspirin may be an explanation for some of these events. Multiple trials have linked aspirin resistance to these adverse events. Objectives: The aim of this study was to estimate the prevalence of aspirin resistance among patients with coronary artery disease (CAD) in Egypt and evaluate its impact on clinical outcome. Methods: A total of 50 patients with documented history of CAD were included; they were on aspirin 150 mg/day for more than seven days and no other antiplatelet drugs. They were evaluated for aspirin resistance using light transmission aggregometry. Aspirin resistance was defined as a mean aggregation of >20% with 0.5 mg/ml arachidonic acid. They were followed up after six months for cardiac death, unstable angina (UA), myocardial infarction (MI), and stroke. Results: Prevalence of aspirin resistance was 48% in our study group. Aspirin resistance was significantly higher in patients with family history of CAD (p = 0.044), smoking (p = 0.011), history of MI (p = 0.024), history of percutaneous coronary intervention (PCI) (p = 0.001), and concomitant NSAIDs intake (p = 0.047). Moreover, aspirin resistance was more common among patients with multi-vessel CAD (p = 0.024). Aspirin-resistant patients had a significantly higher rate of UA (p = 0.001) and all major adverse cardiac events (MACE) (p < 0.001).