ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
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The frequency of aspirin resistance by a modified thrombelastography method and its relationship with clinical and laboratory parameters in patients with stable coronary artery disease [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2012; 40(1): 33-40 | DOI: 10.5543/tkda.2012.01645

The frequency of aspirin resistance by a modified thrombelastography method and its relationship with clinical and laboratory parameters in patients with stable coronary artery disease

Durmuş Yıldıray Şahin1, Mevlüt Koç1, Murat Çaylı1, Onur Kadir Uysal1, Osman Karaarslan1, Mehmet Kanadaşı2, Mustafa Demirtaş2
1Department of Cardiology, Adana Numune Education And Research Hospital, Adana, Turkey
2Department of Cardiology, Çukurova University, Adana, Turkey


OBJECTIVES
Aspirin is the cornerstone of antiplatelet therapy in cardiovascular medicine. However, aspirin resistance has been demonstrated in 0.4% to 83.3% of aspirin-receiving patients. The aim of this study was to investigate the frequency of aspirin resistance using a modified thrombelastography (mTEG) method and related clinical and biochemical parameters in patients with stable coronary artery disease (CAD), who received 100 mg/day aspirin.

STUDY DESIGN
The study included 168 patients (115 males, 53 females; mean age 60±8 years) with stable CAD, receiving aspirin at a dose of 100 mg/day. Aspirin responsiveness was determined using mTEG, where aspirin resistance was defined as arachidonic acid-induced whole blood platelet aggregation inhibition (PAI) of less than 50%.

RESULTS
Aspirin resistance was detected in 27 patients (16.1%). Platelet aggregation inhibition showed negative correlations with hyperlipidemia, smoking, spironolactone use, systolic blood pressure, pulse pressure, and total cholesterol and fibrinogen levels. In multivariate regression analysis, only fibrinogen level (OR=1.063, p=0.010) and pulse pressure (OR=1.197, p=0.023) were found to be independent indicators of aspirin resistance and PAI. In ROC analysis, cut-off values of 50 mmHg for pulse pressure and 400 mg/dl for fibrinogen level predicted aspirin resistance with 88.9% and 74% sensitivity and 64.4% and 68% specificity, respectively.

CONCLUSION
Our findings suggest that measurements of fibrinogen level and pulse pressure may be used as easy and reliable methods in predicting aspirin resistance.

Keywords: Aspirin, blood platelets/drug effects, coronary artery disease, drug resistance; platelet aggregation inhibitors; platelet function tests/methods; thrombelastography

How to cite this article
Durmuş Yıldıray Şahin, Mevlüt Koç, Murat Çaylı, Onur Kadir Uysal, Osman Karaarslan, Mehmet Kanadaşı, Mustafa Demirtaş. The frequency of aspirin resistance by a modified thrombelastography method and its relationship with clinical and laboratory parameters in patients with stable coronary artery disease. Turk Kardiyol Dern Ars. 2012; 40(1): 33-40

Corresponding Author: Durmuş Yıldıray Şahin, Türkiye
Manuscript Language: Turkish


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
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per Paper:
0.22
SCImago Journal Rank: 0.348

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