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Article Dans Une Revue Annals of Hematology Année : 2009

Variability of non-response to aspirin in patients with peripheral arterial occlusive disease during long-term follow-up

Résumé

Non-responsiveness to aspirin as detected by laboratory tests may identify patients at high risk for future vascular events. The aim of this prospective study was to evaluate whether non-responsiveness to aspirin is stable over time. Ninety-eight patients with stable peripheral arterial occlusive disease (PAOD) treated with 100 mg/d aspirin were followed over a median timeframe of 17 months. Platelet function tests were performed initially and at follow-up using arachidonic acid-induced light transmittance aggregometry (LTA) in native platelet-rich plasma with the Behring Coagulation Timer® and by measuring the collagen−epinephrine closure time (CT) on a Platelet Function Analyzer (PFA-100®). When determining platelet function using LTA, four patients (4.1%) had residual platelet function (i.e., MaxAggr ≥78%) despite aspirin treatment, whereas, according to the PFA-100® results, 12 patients (12.2%) were identified as non-responders (i.e., CT <192 s). Fifty-seven patients who were still under treatment with 100 mg/d aspirin at the time of follow-up provided a second blood sample. Further platelet function tests with the PFA-100® system identified a persistent non-responsiveness to aspirin over time in three patients (5.3%) whereas four (7.0%) and 15 (26.3%) patients had changes in response status when platelet function was assessed by LTA and on the PFA-100®, respectively. We conclude that true non-responsiveness to aspirin is a rare phenomenon in stable PAOD patients. Furthermore, we conclude that in a number of patients, aspirin non-responsiveness is not stable over time.
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Dates et versions

hal-00535036 , version 1 (11-11-2010)

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Birgit Linnemann, Stephanie Prochnow, Helen Mani, Jan Schwonberg, Edelgard Lindhoff-Last. Variability of non-response to aspirin in patients with peripheral arterial occlusive disease during long-term follow-up. Annals of Hematology, 2009, 88 (10), pp.979-988. ⟨10.1007/s00277-009-0708-8⟩. ⟨hal-00535036⟩

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